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Journal of Affective Disorders
Journal Prestige (SJR): 2.053
Citation Impact (citeScore): 4
Number of Followers: 17  
 
  Hybrid Journal Hybrid journal (It can contain Open Access articles)
ISSN (Print) 0165-0327
Published by Elsevier Homepage  [3162 journals]
  • Suicidal thoughts and behaviour among South African adolescents living
           with HIV: can social support buffer the impact of stigma'
    • Abstract: Publication date: Available online 14 October 2018Source: Journal of Affective DisordersAuthor(s): Marisa Casale, Mark Boyes, Marija Pantelic, Elona Toska, Lucie Cluver Background: Adolescents living with HIV represent a high-risk population for suicidal ideation and attempts, especially in low-income settings. Yet little is known about risk and protective factors for suicide in this population.MethodsA moderated mediation model was employed to test for potential a) effects of stigma on suicidal ideation and attempts, both direct and mediated through depression and b) direct and stress-buffering effects of social support resources on depression and suicidal ideation and attempts, among 1053 HIV-positive 10-19 year-old adolescents from a resource-scarce health district in South Africa. The survey data was collected using full community sampling of 53 clinics and tracing to over 180 communities. Effects of two support resources were tested: perceived support availability from the adolescents’ social network and structured clinic support groups. Stigma was measured using the ALHIV-SS scale, depression through the CDI short form and social support through items from the MOS-SS.ResultsStigma was a risk factor for depression (B=0.295; p
       
  • Post-stroke depression and cognitive impairment: study design and
           preliminary findings in a Brazilian prospective stroke cohort (EMMA study)
           
    • Abstract: Publication date: Available online 12 October 2018Source: Journal of Affective DisordersAuthor(s): Alessandra Baccaro, Yuan-Pang Wang, Miriam Candido, Adriana Bastos Conforto, André Russowsky Brunoni, Claudia da Costa Leite, Geraldo Busatto Filho, Paulo A Lotufo, Isabela M Benseñor, Alessandra C Goulart BackgroundPost-stroke depression (PSD) and cognitive impairment (PCI) are common conditions. This study aims to describe the protocol and preliminary findings of an investigation into factors associated with PSD and PCI 1-3 months after stroke (subacute phase) in survivors from the Study of Stroke Mortality and Morbidity (EMMA study).MethodsStroke patients underwent to clinical and neurological evaluations on admission to hospital. Cerebral magnetic resonance and biomarkers (serotonin, BDNF, IL-6 and IL-18) were carried out in the subacute phase. DSM-IV major depression for the diagnosis of PSD, cognitive functioning for the diagnosis of PCI and functional disability were also recorded at same time.ResultsOf the 103 eligible patients, 85.4% had ischemic stroke and 73.7% had first-ever stroke. In the subacute phase, 27.2% had PCI and 13.6% had current PSD (5.8% with ‘first episode’ and 7.8% with ‘recurrent’ depression). PCI was associated with low education (0-7 years of formal education: 75%) and ageing (median age: 70; interquartile range: 59-75 y-old). Left-sided stroke was more frequently associated with increased PCI than right-sided stroke (71.4% vs. 28.4%, p=0.005). PSD was neither associated with stroke laterality nor tentorial area. Overall, biomarkers levels were not alterated in patients with PSD and PCI.LimitationsFindings are based on small sample and less disabled stroke participants, e.g. those without aphasia and deafness.ConclusionsFindings reinforce the need of early recognition and rehabilitation of PCI and PSD, mainly among those less educated and with left-sided stroke. PSD might occur through a pathophysiological pathway other than classical depression.
       
  • Stigma, grief and depressive symptoms in help-seeking people bereaved
           through suicide
    • Abstract: Publication date: Available online 11 October 2018Source: Journal of Affective DisordersAuthor(s): P Scocco, A Preti, S Totaro, PW Corrigan, C Castriotta, The SOPROXI Team BackgroundThe painful experience of mourning after suicide can be further complicated by the stigma surrounding suicide survival. We investigated how grief and depression influence the perception of stigma towards survivors in a sample of help-seeking persons bereaved through suicide.MethodsCross-sectional design. Information on sociodemographic variables and responses to the Stigma of Suicide Survivor scale, Beck Depression Inventory (BDI) and Inventory of Complicated Grief (ICG) was collected from 240 people bereaved through suicide who consecutively accessed an online support initiative.ResultsDespite the strong correlation between ICG and BDI scores, the intensity of depressive but not of grief symptoms was related to perceived stigma towards survivors. Time since loss was also positively related to levels of perceived stigma against survivors. The links between depression and perceived stigma persisted after taking into account relationship with the deceased and other sociodemographic factors.LimitationsThe main study limitations are the cross-sectional design, reliance on self-report measures, and the self-selection of the sample of people bereaved through suicide, seeking help through a website. Social support was not measured and the sample included a large proportion of women.ConclusionsSpecific interventions designed for persons bereaved by suicide should consider that psychological distress and mourning are qualitatively different reactions to a suicide loss. The relationship among perceived stigma, depressive suffering and time elapsed since the suicide loss suggests the usefulness of closely investigating the experience of stigma in all people bereaved through suicide with depressive symptoms, even long after the event.
       
  • Gray matter differences between affective and non-affective first episode
           psychosis: A review of Magnetic Resonance Imaging studies: Special Section
           on “Translational and Neuroscience Studies in Affective Disorders”
           Section Editor, Maria Nobile MD, PhD. This Section of JAD focuses on the
           relevance of translational and neuroscience studies in providing a better
           understanding of the neural basis of affective disorders. The main aim is
           to briefly summaries relevant research findings in clinical neuroscience
           with particular regards to specific innovative topics in mood and anxiety
           disorders
    • Abstract: Publication date: 15 January 2019Source: Journal of Affective Disorders, Volume 243Author(s): A. Calvo, G. Delvecchio, A.C. Altamura, J.C. Soares, P. Brambilla BackgroundNon-affective and affective psychoses are very common mental disorders. However, their neurobiological underpinnings are still poorly understood. Therefore, the goal of the present review was to evaluate structural Magnetic Resonance Imaging (MRI) studies exploring brain deficits in both non-affective (NA-FEP) and affective first episode psychosis (A-FEP).MethodsA bibliographic search on PUBMED of all MRI studies exploring gray matter (GM) differences between NA-FEP and A-FEP was conducted.ResultsOverall, the results from the available evidence showed that the two diagnostic groups share common GM alterations in fronto-temporal regions and anterior cingulate cortex. In contrast, unique GM deficits have also been observed, with reductions in amygdala for A-FEP and in hippocampus and insula for NA-FEP.LimitationsFew small MRI studies with heterogeneous methodology.ConclusionsAlthough the evidences are far to be conclusive, they suggest the presence of common and distinct pattern of GM alterations in NA-FEP and A-FEP. Future larger longitudinal studies are needed to further characterize specific neural biomarkers in homogenous NA-FEP and A-FEP samples.
       
  • MRI features of clinical outcome in bipolar disorder: A selected review:
           Special Section on “Translational and Neuroscience Studies in Affective
           Disorders”. Section Editor, Maria Nobile MD, PhD. This Section of JAD
           focuses on the relevance of translational and neuroscience studies in
           providing a better understanding of the neural basis of affective
           disorders. The main aim is to briefly summaries relevant research findings
           in clinical neuroscience with particular regards to specific innovative
           topics in mood and anxiety disorders
    • Abstract: Publication date: 15 January 2019Source: Journal of Affective Disorders, Volume 243Author(s): N. Dusi, V. De Carlo, G. Delvecchio, M Bellani, J.C. Soares, P. Brambilla BackgroundBipolar disorder (BD) is a severe and disabling mental illness, which is characterized by selective gray matter (GM) and white matter (WM) brain alterations, as observed by several imaging studies. However, the clinical course of the disease is uncertain and can vary across BD patients, with some having a benign course and others a severe disability. In this perspective, magnetic resonance imaging (MRI) can help identifying biological markers of worse prognosis.MethodsThe present selected review aimed at summarizing structural MRI (sMRI) studies exploring the correlation between brain morphology and features of clinical outcome, which could include treatment response, cognitive impairment and global functioning.ResultsOverall, the results from the reviewed sMRI studies reported that WM hyperintensities and GM volume reductions, mainly in fronto-limbic areas, correlate with worse outcome in BD. However, the selected outcome measures vary across studies, thus these observations cannot be conclusive.LimitationsHeterogeneity across studies and inconsistency on the outcome measures adopted limit the conclusion of the present review. Absence of widely shared definitions of outcome should be object of further research on BD in order to indicate more stable features of illness course.ConclusionsIn summary, WM hyperintensities and fronto-temporo-limbic GM alterations may be potential indices of worse outcome in BD patients, particularly in terms of illness severity and progression. The identification of stable markers of prognosis can help the clinicians in selecting subgroups of bipolar patients who need specific treatment to preserve cognitive / psychosocial functioning, in the light of personalized approaches. To further characterize outcome in BD, future sMRI studies should a) longitudinally investigate patients with either poor or good course of the disease, and b) correlate neuroimaging measures with clinical, cognitive and genetic markers.
       
  • Childhood Narcissism: A Call for Interventions
    • Abstract: Publication date: Available online 11 October 2018Source: Journal of Affective DisordersAuthor(s): Eddie Brummelman, Çisem Gürel
       
  • Genetic and Environmental Effects on the Development of Depressive
           Symptoms from Adolescence to Adulthood in a Nationally Representative
           Sample
    • Abstract: Publication date: Available online 11 October 2018Source: Journal of Affective DisordersAuthor(s): Albert J. Ksinan, Alexander T. Vazsonyi BackgroundPrevious research has shown substantial heritability for depressive symptoms, yet, there are few genetically-informed studies which focused on developmental changes. The current study sought to model prototypical developmental trajectories of depressive symptoms from adolescence to adulthood and to elucidate genetic and environmental contributions to these changes.MethodsThe Add Health data set, a nationally representative sample of adolescents, was used. For the genetically-informed analyses, a subsample of N = 531 same-sex monozygotic and dizygotic male and female twin pairs was selected. Longitudinal development was modeled separately for two waves in early adolescence and for four waves from middle adolescence to young adulthood using a latent growth model (LGM). Both models were extended to twin models to estimate the effects of heritability and the environment.ResultsThe rates of depressive symptoms peaked in mid-adolescence and then sharply declined as individuals moved from adolescence to young adulthood, with leveling off in the twenties. The effects of the shared environment were substantial among early adolescents, but negligible for middle-to-late adolescents. An opposite pattern was found for heritability. The largest proportion of developmental changes was driven by nonshared environmental effects.LimitationsThe study only used same-sex twins as there exist mixed findings regarding the possibility of qualitative or quantitative genetic effects.ConclusionsThe salience of unique experiences and to a lesser extent, heritable factors in affecting developmental changes in depressive symptoms, underscore the need for targeting such environments that place individuals with genetic predisposition at double the risk for the development of depression.
       
  • Diverse Pathophysiological Processes Converge on Network Disruption in
           Mania
    • Abstract: Publication date: Available online 10 October 2018Source: Journal of Affective DisordersAuthor(s): Ms Ivy Lee, Ms Ivy Lee BackgroundNeuroimaging of psychiatric disease is challenged by the difficulty of establishing the causal role of neuroimaging abnormalities. Lesions that cause mania present a unique opportunity to understand how brain network disruption may cause mania in both lesions and in bipolar disorder.MethodsA literature search revealed 23 case reports with imaged lesions that caused mania in patients without history of bipolar disorder. We traced these lesions and examined resting-state functional Magnetic Resonance Imaging (rsfMRI) connectivity to these lesions and control lesions to find networks that would be disrupted specifically by mania-causing lesions. The results were then used as regions-of-interest to examine rsfMRI connectivity in patients with bipolar disorder (n=16) who underwent imaging longitudinally across states of both mania and euthymia alongside a cohort of healthy participants scanned longitudinally. We then sought to replicate these results in independent cohorts of manic (n=26) and euthymic (n=21) participants with bipolar disorder.ResultsMania-inducing lesions overlap significantly in network connectivity. Mania-causing lesions selectively disrupt networks that include orbitofrontal cortex, dorsolateral prefrontal cortex, and temporal lobes. In bipolar disorder, the manic state was reflected in strong, significant, and specific disruption in network communication between these regions and regions implicated in bipolar pathophysiology: the amygdala and ventro-lateral prefrontal cortex.LimitationsThe was heterogeneity in the clinical characterization of mania causing lesions.ConclusionsLesions causing mania demonstrate shared and specific network disruptions. These disruptions are also observed in bipolar mania and suggest a convergence of multiple disorders on shared circuit dysfunction to cause mania.
       
  • Adult Outcomes of Childhood Disruptive Disorders in Offspring of Depressed
           and Healthy Parents
    • Abstract: Publication date: Available online 10 October 2018Source: Journal of Affective DisordersAuthor(s): Alexandre Paim Diaz, Connie Svob, Ruixin Zhao, Baxter DiFabrizio, Virginia Warner, Marc J. Gameroff, Jamie Skipper, Jay Gingrich, Jonathan Posner, Priya J. Wickramaratne, Myrna M. Weissman, Ardesheer Talati BackgroundLongitudinal studies of children with disruptive disorders (DDs) have shown high rates of antisocial personality disorder (ASPD) and substance use in adulthood, but few have examined the contribution of parental disorders. We examine child-/adulthood outcomes of DDs in offspring, whose biological parents did not have a history of ASPD, bipolar disorder, or substance use disorders.MethodOffspring (N=267) of parents with or without major depression (MDD), but no ASPD or EDs were followed longitudinally over 33 years, and associations between DDs and psychiatric and functional outcomes were tested.ResultsEighty-nine (33%) offspring had a DD. Those with, compared to without DDs, had higher rates of MDD (adjusted odds ratio, AOR=3.42, p
       
  • Alterations in Patients with Major Depressive Disorder Before and After
           Electroconvulsive Therapy Measured by Fractional Amplitude of
           Low-Frequency Fluctuations (fALFF)
    • Abstract: Publication date: Available online 9 October 2018Source: Journal of Affective DisordersAuthor(s): Haitang Qiu, Xinke Li, Qinghua Luo, Yongming Li, Xichuan Zhou, Hailin Cao, Yuanhong Zhong, Mingui Sun BackgroundElectroconvulsive therapy (ECT) is an important treatment option for patients with major depressive disorder (MDD). However, the mechanisms of ECT in MDD are still unclear.MethodsTwenty-four patients with severe MDD and 14 healthy controls were enrolled in this study. Eight ECT sessions were conducted for MDD patients using brief-pulse square-wave signal at bitemporal locations. To investigate the regional cerebral blood flow in MDD patients before and after ECT treatments by resting-state functional magnetic resonance imaging (rs-fMRI), the patients were scanned twice (before the first ECT and after the eighth ECT) for data acquisition. Afterward, we adopted fractional amplitude of low-frequency fluctuations (fALFF) to assess the alterations of regional brain activity.ResultsCompared with healthy controls, the fALFF in the cerebellum lobe, parahippocampal gyrus, fusiform gyrus, anterior cingulate gyrus, and thalamus in MDD patients before ECT (pre-ECT) was significantly increased. In another comparison, the fALFF in the cerebellum anterior lobe, fusiform gyrus, insula, parahippocampal gyrus, middle frontal gyrus, and inferior frontal gyrus in pre-ECT patients was significantly greater than the post-ECT fALFF.LimitationsOnly two rs-fMRI scans were conducted at predefined times: before the first and after the eighth ECT treatment. More scans during the ECT sessions would yield more information. In addition, the sample size in this study was limited. The number of control subjects was relatively small. A larger number of subjects would produce more robust findings.ConclusionsThe fALFF of both healthy controls and post-ECT patients in cerebellum anterior lobe, fusiform gyrus, and parahippocampal gyrus is significantly lower than the fALFF of pre-ECT patients. This finding demonstrates that ECT treatment is effective on these brain areas in MDD patients.
       
  • Childhood sexual abuse, poly-victimization and internalizing disorders
           across adulthood and older age: Findings from a 25-year longitudinal study
           
    • Abstract: Publication date: Available online 9 October 2018Source: Journal of Affective DisordersAuthor(s): Charlene M. Rapsey, Kate M. Scott, Tess Patterson BackgroundWe aimed to investigate associations between childhood sexual abuse and maltreatment and internalizing disorders (anxiety, depression, PTSD) across adulthood.MethodsFollowing a postal survey of 2,220 women, a subsample was selected to participate in an interview. The subsample included 276 women reporting childhood sexual abuse and 221 women with no reported history of childhood sexual abuse. Interviews were repeated six and 25 years following the first interview. Internalizing disorders were assessed using ICD-8 and DSM-III criteria.ResultsThere was a lower probability of having an internalizing disorder at older ages than younger ages for all women, regardless of maltreatment history. Latent class analysis was used to define three classes (no/low maltreatment, sexual abuse, poly-victimisation). Compared with no/low maltreatment, a history of childhood sexual abuse was associated with almost double the risk of an internalizing disorder and a history of poly-victimisation was associated with over four times the risk of an internalizing disorder. Childhood sexual abuse and poly-victimisation remained associated with an elevated risk of a disorder in older age.LimitationsFindings are limited by attrition (39% participated at Time 3), low prevalence of severe physical abuse, and changes in assessment practice of childhood maltreatment and mental disorder in the past 30 years.ConclusionsScreening and treatment for internalizing disorders in women with histories of childhood maltreatment remains important in older aged populations.
       
  • Light up ADHD: II. Neuropharmacological effects measured by Near Infrared
           Spectroscopy: is there a biomarker'
    • Abstract: Publication date: Available online 9 October 2018Source: Journal of Affective DisordersAuthor(s): Grazioli Silvia, Mauri Maddalena, Crippa Alessandro, Maggioni Eleonora, Molteni Massimo, Brambilla Paolo, Nobile MariaABSTRACTBackgroundAttention deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterized by deficits in self-controlling attention, behavior, and emotions. In recent years, noninvasive optical techniques, such as near infrared spectroscopy (NIRS), have been used to measure the neural correlates of pharmacological-therapy outcomes in children and adolescents with ADHD.MethodsWe reviewed a short series of articles that investigated the results of functional NIRS (fNIRS) on developmental-age ADHD. The review was limited to fNIRS studies that investigated the cortical responses that occurred during neuropsychological tasks in ADHD patients who received methylphenidate or atomoxetine.ResultsThe majority of the reviewed studies revealed the presence of increased oxygenated hemoglobin concentrations in the prefrontal cortex following pharmacotherapy in ADHD samples. A higher frequency of right-lateralized results was found.LimitationsThe considered studies are characterized by substantial methodological heterogeneity in terms of the patients’ medication status and washout period, explored cerebral regions, and neuropsychological tasks.ConclusionsfNIRS seems to be a promising tool for the detection of pharmacological-treatment biomarkers in samples of children and adolescents with ADHD.
       
  • Lithium monotherapy-induced tardive dyskinesia
    • Abstract: Publication date: Available online 9 October 2018Source: Journal of Affective DisordersAuthor(s): Konstantinos N. Fountoulakis, Thomas Tegos, Vasilios Kimiskidis Tardive dyskinesia is a movement disorder that develops during the course of long-term treatment with neuroleptic agents and is characterized primarily by choreiform and athetotic movements. We report the case of a 68-year old female suffering from Bipolar disorder, treated with lithium monotherapy 600 mg per day (serum levels 0.6) for the last 15 years. While her response was favorable she was rarely visiting the outpatient clinic. Over the last few months she developed a tardive dyskinesia-like syndrome. To our knowledge this is the first reported case of tardive dyskinesia with lithium monotherapy at low dosages.
       
  • Clinical characteristics of obstructive sleep apnea in bipolar disorders.
    • Abstract: Publication date: Available online 9 October 2018Source: Journal of Affective DisordersAuthor(s): Pierre A. Geoffroy, Jean-Arthur Micoulaud Franchi, Julia Maruani, Pierre Philip, Carole Boudebesse, Chloé Benizri, Sunthavy Yeim, Victoire Benard, Helena Brochard, Marion Leboyer, Frank Bellivier, Bruno Etain BackgroundObstructive sleep apnea (OSA) is one of the leading non-psychiatric comorbidities in bipolar disorders (BD). We sought to explore associations between risk of OSA in BD, clinical characteristics alongside with both subjective sleep complaints and objective sleep abnormalities.MethodsEuthymic patients with BD (n=144) were assessed over a three-week period, by actigraphy, clinical interviews and questionnaires.ResultsOf the study sample, 32 (22%) individuals were at high risk of OSA (HR-OSA) and 112 (78%) had a low risk (LR-OSA), as assessed with the Berlin questionnaire. HR-OSA, compared to LR-OSA, were older (p=0.031), had higher BMI (p
       
  • Borderline Personality Disorder Traits and Suicide Risk: The Mediating
           Role of Insomnia and Nightmares
    • Abstract: Publication date: Available online 9 October 2018Source: Journal of Affective DisordersAuthor(s): Hilary L. DeShong, Raymond P. Tucker Background: Borderline personality disorder (BPD) is associated with high rates of suicide risk and problems related to sleep, including insomnia and nightmares. The purpose of the current study was to assess the potential indirect effect of BPD traits on suicide risk through both/either insomnia and nightmares.Methods: Participants (N=281) were recruited via Amazon's Mechanical Turk to complete the study remotely online. Participants completed measures of BPD traits and symptoms, suicide risk (history of suicidal thoughts and behaviors), insomnia symptoms, and distress and impairment related to nightmares.Results: BPD traits and symptoms were moderately to highly correlated to suicide risk, insomnia, and nightmares. In parallel mediation models, BPD traits had a significant indirect effect on suicide risk through insomnia symptoms but not nightmares.Limitations: The current study assessed problems within the general population and not in a clinical sample. Second, the study relied solely on self-report measures. Futures studies would benefit from investigating these relations in clinical samples utilizing observer-report and interview methods.Conclusions: BPD traits appear to relate to increased risk for suicide through the relation with sleep concerns, particularly insomnia symptoms. Therefore, assessing and treating sleep problems within individuals with BPD may result in a lower risk for suicide.
       
  • Predictors of depressive symptoms in college students: A systematic review
           and meta-analysis of cohort studies
    • Abstract: Publication date: Available online 6 October 2018Source: Journal of Affective DisordersAuthor(s): Yan Liu, Ning Zhang, Guangyi Bao, Yubei Huang, Bingyuan Ji, Yili Wu, Chuanxin Liu, Gongying Li BackgroundTo explore predictors of depressive symptoms in college students.MethodsWe performed a systematic review and meta-analysis on the predictors of depressive symptoms. PubMed/Medline, Embase, Springerlink, EBSCOhost, Cochrane review, PsycINFO, China Knowledge Resource Integrated Database, Weipu database and Wanfang database were searched for cohort or longitudinal studies. Stata version 13.1 was used for statistical meta-analysis.ResultsAmong 30 cohort studies, 24 studies covering 25,154 college students with the NOS of 6 and over were selected for systematic review and 15 studies met the inclusion criteria for meta-analysis. The predictors of depressive symptoms in college students were gender, baseline depression, neuroticism or psychoticism, negative automatic thoughts or negative rumination, dysfunctional attitude, childhood abuse, sex abuse, and stressful life events. The combined risk ratios and its 95% confidence interval (CI) of each previous predictors were 1.11 (95% CI: 1.02, 1.21), 1.28(95% CI: 1.10, 1.45), 1.25 (95% CI: 1.04, 1.45), 1.03 (95% CI: 1.01,1.05), 1.17 (95% CI: 1.05, 1.29), 1.05(95% CI: 1.02,1.08), 1.01 (95% CI: 1.00,1.02), and 1.16 (95% CI: 1.04, 1.27), respectively. Perceived social support and family function did not displayed significant predictive effects. Funnel plots showed that publication bias was possible.LimitationsScreening tools for depressive symptoms do not have the power or specificity of the gold standard measures for depression like the Structured Clinical Interview (SCID) or the Composite International Diagnostic Interview (CIDI) based on Diagnostic and Statistical Manual of Mental Disorders (DSM), which would influence the study validity and the combined estimates.ConclusionsSpecific biological, psychological and environmental factors contribute to depressive symptoms in college students. Consideration of these prognostic factors might be conducive to improve understanding and management of future interventions against depressive symptoms among college students. Due to the highly sophisticated course of depression, it is crucial to summarize theoretical frameworks for depressive symptom interventions among college students.
       
  • Inflammation associated with volume reduction in the gray matter and
           hippocampus of older patients with bipolar disorder
    • Abstract: Publication date: Available online 6 October 2018Source: Journal of Affective DisordersAuthor(s): Shang-Ying Tsai, Ariel G. Gildengers, Jung-Lung Hsu, Kuo-Hsuan Chung, Pao-Huan Chen, Yu-Jui Huang BackgroundBipolar disorder (BD) and aging appear to be associated with inflammatory activation. Inflammatory processes might affect hippocampal function, neurogenesis, and gray matter loss. This study investigated the relationship between BD-specific brain regions and the total gray matter volume, peripheral inflammatory markers, and clinical features in older patients with BD.MethodsWe recruited euthymic patients with bipolar I disorder aged ≥50 years to undergo whole-brain magnetic resonance imaging. Each brain region was divided by an individual's total intracranial volume to obtain that brain region's volume in percentage relative to the total intracranial volume. We measured the plasma levels of soluble tumor necrosis factor receptor-1 (sTNF-R1), soluble interleukin (IL)-2 receptor (sIL-2R), sIL-6R, IL-1β, and IL-1 receptor antagonist when patients were euthymic. Clinical data were obtained by reviewing available medical records and interviewing patients along with their reliable others.ResultsThere were 32 patients with a mean age of 61.2 ±8.3 years and a mean age at illness onset of 33.4 ±13.8 years in this study. Stepwise regression showed that the right hippocampal volume was negatively associated with the levels of sIL-2R and sTNF-R1. The left hippocampal volume were negatively associated with the sIL-2R level and body mass index. The total gray matter volume had an inverse relationship with sTNF-R1 and IL-1β levels. The duration of bipolar illness, lithium treatment, and antipsychotic use were not associated with hippocampal and total gray matter volumes.ConclusionsIt is suggested that persistent inflammation is associated with reduction of hippocampal and gray matter volumes in older patients with BD. This phenomenon is supported by increases in sTNF-R1, sIL-2R, and IL-1β levels. Neuroinflammation due to aging, obesity, and BD pathophysiology may play a role in BD neuroprogression across the life span.
       
  • Effect of Self-Monitoring Through Experience Sampling on Emotion
           Differentiation in Depression
    • Abstract: Publication date: Available online 6 October 2018Source: Journal of Affective DisordersAuthor(s): Raf L.A. Widdershoven, Marieke Wichers, Peter Kuppens, Jessica A. Hartmann, Claudia Menne-Lothmann, Claudia J.P. Simons, Jojanneke A. Bastiaansen BackgroundMajor depressive disorder has been linked to an inability to differentiate between negative emotions. The current study investigates whether emotion differentiation improves when individuals with major depressive disorder are required to report on specific emotions multiple times a day through the experience sampling method (ESM) – a structured self-report diary technique.MethodsSeventy-nine patients diagnosed with major depressive disorder participated in this study, of whom 55 used ESM for 6 weeks (3 days a week, 10 times a day). Changes from baseline to post assessment in positive and negative emotion differentiation were compared between the participants who did and those who did not use ESM.ResultsEngaging in ESM related to an improvement in both positive and negative emotion differentiation, but only the latter reached statistical significance. The relationship between the number of ESM measurements (dose) and emotion differentiation change (response) was not significant.LimitationsThe sample size for the dose-response analysis was relatively small (N=55). It is unknown whether emotion differentiation improvements generalize beyond the emotions (N=12) we probed in this study. Other factors could also have contributed to the change (e.g. meetings with the researchers).ConclusionsThe present study suggests that patients with depression using ESM for 3 days a week for 6 weeks can improve their negative emotion differentiation. Future studies should assess after what period of ESM changes in emotion differentiation become apparent, and whether these changes are persistent and relate to actual improvement in depressive symptoms.
       
  • Disentangling the Association of Depression on the Anti-fatigue Effects of
           Ketamine
    • Abstract: Publication date: Available online 6 October 2018Source: Journal of Affective DisordersAuthor(s): Leorey N. Saligan, Cristan Farmer, Elizabeth D. Ballard, Bashkim Kadriu, Carlos A. Zarate BackgroundFatigue and depression are closely associated. The purpose of this secondary analysis was to understand the relationships between depression and improvements in specific depression domains on the anti-fatigue effects of ketamine, which we previously reported.MethodsThis secondary analysis re-evaluated data collected longitudinally from 39 patients with treatment-resistant Major Depressive Disorder (MDD) enrolled in a double-blind, randomized, placebo-controlled, crossover trial using a single intravenous infusion of ketamine hydrochloride (0.5mg/kg over 40 minutes) or placebo. A mediation model assessed the effect of depression on the anti-fatigue effects of a single dose of intravenous ketamine versus placebo at Day 1 post-infusion. Fatigue was measured using the National Institutes of Health – Brief Fatigue Inventory (NIH-BFI), and depression was assessed by the Montgomery-Ǻsberg Depression Rating Scale (MADRS).ResultsCompared to placebo, ketamine significantly improved fatigue (p=.0003) as measured by the NIH-BFI, but the anti-fatigue effects of ketamine disappeared (p=.47) when controlling for depression as measured by MADRS total score. In this study sample, the anti-fatigue effects of ketamine were mostly accounted for by the changes in amotivation and depressed mood scores.ConclusionsIn this study, ketamine did not have a unique effect on fatigue outside of its general antidepressant effects in patients with treatment-resistant depression. Specifically, the anti-fatigue effects of ketamine observed in this study seem to be explained by the effects of ketamine on two symptom domains of depression: amotivation and depressed mood. The study findings suggest that the anti-fatigue effects of ketamine should be assessed by fatigue-specific measures other than the NIH-BFI or future studies should enroll fatigued patients without depression.
       
  • OLIGOPEPTIDASES ACTIVITY IN BIPOLAR DISORDER: NDEL1 AND ANGIOTENSIN I
           CONVERTING ENZYME
    • Abstract: Publication date: Available online 6 October 2018Source: Journal of Affective DisordersAuthor(s): Caroline Dal Mas, Michelle S. Carvalho, Lucas A. Marins, Camila M. Yonamine, Quirino Cordeiro, Roger S. McIntyre, Rodrigo B. Mansur, Elisa Brietzke, Mirian A.F. Hayashi BackgroundAbnormal activity of two enzymes relevant to neurodevelopment, namely nuclear-distribution element-like 1 (Ndel1) and angiotensin I-converting enzyme (ACE), was reported in individuals with schizophrenia; to our knowledge, these oligopeptidases were never measured in bipolar disorder (BD). Aims: Evaluate the enzyme activity of Ndel1 and ACE in euthymic individuals with BD type 1 which was compare to healthy control (HC) group.MethodsNdel1 and ACE activities were assessed in the serum of individuals with BD type 1 according to DSM-IV criteria (n = 70) and a HC group (n = 34). The possible differences between BD type 1 and HC groups were evaluated using Analysis of Covariance (ANCOVA), and the results were adjusted for age, gender and body mass index.ResultsWe observed a positive correlation between Ndel1 activity and the total YMRS score in BD group (p = 0.030) and a positive correlation between ACE activity and Ham-D score (p = 0.047). ANCOVA analysis showed lower Ndel1 activity in BDs compared to HCs. Interestingly, we did not observe between-groups differences in ACE activity, despite the recognized correlation of ACE activity levels with cognitive functions, also described to be worsened in psychiatric patients.ConclusionOligopeptidases, especially Ndel1, which has been strongly correlated with neurodevelopment and brain formation, are potentially a good new target in the study of the neurobiology of BD.LimitationsThe relatively small sample size did not permit to examine the cause-effect relationship of clinical dimensions of BD and the enzymatic activity.Graphical abstractImage, graphical abstract
       
  • Changes in levels of cortical metabotropic glutamate 2 receptors with
           gender and suicide but not psychiatric diagnoses
    • Abstract: Publication date: Available online 6 October 2018Source: Journal of Affective DisordersAuthor(s): Brian Dean, Clare Duncan, Andrew Gibbons BackgroundWe previously reported that, compared to controls, there are lower levels of [3H]LY341495 binding to metabotropic 2/3 receptors (GRM2/3) in Brodmann's area (BA) 24, but not 17 or 46, from subjects with major depressive disorders (MDD) but not bipolar disorders (BD) or schizophrenia. To be able to better interpret these data we have now measured levels of GRM2 in two of these cortical regions.MethodsUsing a rabbit anti-metabotropic GRM2 monoclonal antibody with Western blotting we measured levels of GRM2 in BA 24 and 46 from subjects with MDD, BD, schizophrenia and controls (n = 15 per group).ResultsCompared to controls, levels of GRM2, normalised to β-actin, did not differ in BA 24 or 46 from subjects with MDD, BD or schizophrenia (p from 0.36 to 0.79). Levels of GRM2 in BA 46, but not BA 24, were significantly higher in males compared to females (p < 0.01) and in suicide completers (p < 0.01) compare to death by other causes.LimitationsOur cohort sizes, whilst being comparable to many postmortem CNS studies, are relatively low.ConclusionsOur data suggests levels of GRM2 are not altered in two cortical regions from subjects with mood disorders or schizophrenia. Given we have found lower levels of [3H]LY341495 binding to GRM2/3 in BA 24 from subjects with MDD, our new data argues the lower levels of radioligand binding was due to lower levels of GRM3. Our data also suggests that glutamatergic activity through GRM2 in BA 46 may differ with gender and suicide ideation.
       
  • Preliminary evidence of an association between increased cortical
           inhibition and reduced suicidal ideation in adolescents treated for major
           depression
    • Abstract: Publication date: 1 February 2019Source: Journal of Affective Disorders, Volume 244Author(s): Charles P. Lewis, Deniz Doruk Camsari, A. Irem Sonmez, Aiswarya Lakshmi Nandakumar, Marjorie A. Gresbrink, Zafiris J. Daskalakis, Paul E. Croarkin BackgroundSuicide is a leading cause of death among youth. Prior research using transcranial magnetic stimulation (TMS) has implicated deficits in GABAergic cortical inhibition in adolescent suicidal behavior, yet no studies have assessed whether cortical inhibition varies over time in conjunction with changes in suicidal ideation (SI). This study examined dynamic changes in long-interval intracortical inhibition (LICI), a TMS measure of GABAB-mediated inhibition, and their relationship with changes in SI in a small sample of adolescents undergoing pharmacologic treatment for depression.MethodsTen depressed adolescents (aged 13–17) underwent clinical assessment and TMS testing at baseline and again at follow-up. All were treated with antidepressant medication in the interim. SI was measured with the Columbia Suicide Severity Rating Scale (C-SSRS) Intensity of Ideation subscale. LICI was measured at interstimulus intervals of 100 and 150 ms.ResultsThere was a significant partial correlation, controlling for change in depression severity, between ΔLICI-100 and change in SI as measured by ΔC-SSRS (ρ = .746, df = 7, p = .021), which remained after also controlling for time to follow-up assessment (ρ = .752, df = 6, p = .032). No significant correlation was observed between ΔLICI-150 and change in SI.LimitationsSample size; variable follow-up interval; inability to control for age, sex, and potential treatment effects.ConclusionsThese data offer preliminary signal of an association between increases in GABAB-mediated cortical inhibition and reduction in SI over time in adolescents treated for depression. Further studies are warranted to explore the role of cortical inhibition in adolescent suicidal ideation and behavior.
       
  • Correlation between depression/anxiety symptom severity and quality of
           life in patients with major depressive disorder or bipolar disorder
    • Abstract: Publication date: 1 February 2019Source: Journal of Affective Disorders, Volume 244Author(s): Keming Gao, Meilei Su, Jennifer Sweet, Joseph R. Calabrese ObjectiveTo study the correlation between depression/anxiety severity and the quality of life (QOL) in patients with major depressive disorder (MDD) or bipolar disorder (BP).MethodsTwo hundred forty-three outpatients diagnosed with MDD or BP were used to study the relationship between depression/anxiety severity and QOL. Depression and anxiety symptom-severity were measured with the QIDS-16-SR (the 16 Item Quick Inventory of Depressive Symptomatology – Self Report), and Zung-SAS (Zung Self-Rating Anxiety Scale). The QOL was measured with the Q-LES-Q short-form (the Quality of Life, Enjoyment and Satisfaction Questionnaire). Correlation was assessed with regression analysis.ResultsThe percentage of maximum possible scores (MPS) of Q-LES-Q was 72.1%, 70.5%, and 67.6% for euthymic MDD, BPI, and BPII, respectively. Increases in QIDS-16-SR total scores significantly correlated to decreases in Q-LES-Q total scores, with an R2 = 0.61, R2 = 0.52, and R2 = 0.45 for MDD, BPI, and BPII, respectively. Increases in Zung-SAS scores also significantly correlated to decreases in Q-LES-Q total scores with an R2 = 0.20, R2 = 0.21, and R2 = 0.12 for MDD, BPI, and BPII. However, after controlling for depression severity, significant differences between Q-LES-Q and Zung-SAS scores disappeared in MDD and BP. After controlling for anxiety and other clinical variables, the negative correlation between QIDS-16-SR and Q-LES-Q scores remained significant in MDD and BP.ConclusionsIn this outpatient sample, the MPS of Q-LES-Q in euthymic MDD and BP patients was at the lower end of non-psychiatric or medical community norm spectrum. Depression severity was the only independent variable negatively correlated to the QOL in both disorders.
       
  • Sleep and circadian rhythms as possible trait markers of suicide attempt
           in bipolar disorders: An actigraphy study
    • Abstract: Publication date: 1 February 2019Source: Journal of Affective Disorders, Volume 244Author(s): V. Benard, B. Etain, G. Vaiva, C. Boudebesse, S. Yeim, C. Benizri, H. Brochard, F. Bellivier, P.A. Geoffroy BackgroundThe poor prognostic of Bipolar disorders (BD) is closely linked to deaths by suicide. Sleep and circadian abnormalities are observed during all phases of BD and are also associated with suicide attempt (SA). In this context, this study sought to identify specific sleep and circadian rhythms markers associated with suicidal attempt in euthymic patients with BD.MethodsThe sample (N = 236) comprised 3 groups: 147 patients with BD including 57 with a history of SA and 90 without (NoSA), and 89 healthy controls (HC). All participants were recorded during 21 days with actigraphy.ResultsSA was associated with women gender (p = 0.03), familial history of SA (p = 0.03), mixed episodes (p = 0.001), and benzodiazepines (p = 0.019). SA, compared to noSA, had a morning phase preference (p = 0.04), and were more vigorous on the circadian type inventory (p = 0.04), and tended to suffer more from insomnia (45% versus 25% respectively, p = 0.10). SA was also associated with an earlier onset of daily activity assessed with actigraphy (M10 onset: p = 0.01). Backward stepwise linear regression indicated that a combination of four variables (Gender, vigour, insomnia, M10onset) significantly differentiated patients with SA from NoSA (p = 0.03).LimitationsCross-sectional design, and no examination of suicidal behaviors’ subgroups such as first attempters or repeaters, or violent suicide attempt.ConclusionsWoman gender, vigorous circadian type, insomnia and an earlier daily activity appeared independently associated with SA in BD. If these biomarkers are confirmed in prospective studies, they should be screened and used to prevent suicide, with the development of personal and targeted chronobiological treatments.
       
  • An evaluation of suicide prevention hotline results in Taiwan: Caller
           profiles and the effect on emotional distress and suicide risk
    • Abstract: Publication date: 1 February 2019Source: Journal of Affective Disorders, Volume 244Author(s): Fortune Fu-Tsung Shaw, Wen-Hsien Chiang BackgroundHotlines are among commonly available and recommended suicide prevention strategies in many countries, but only a few empirical studies have focused on people who used this service and the proximal outcomes of calls made to the hotlines. This study is designed to investigate the demographic characteristics of the Taiwan National Suicide Prevention Hotline (NSPH) callers and whether the NSPH service helps to alleviate the callers’ emotional distress and suicide risk.MethodsDescriptive statistics were used to describe the gender, age and county/city distribution of the 63,696 callers from 2009 to 2011. Three hundred telephone records of 100 acute suicidal callers, 100 suicidal callers, and 100 non-suicidal callers were then randomly selected for further investigation of the proximal changes in the callers’ emotional disturbance and suicidality.ResultsNotwithstanding the suicide status of the callers, significant decreases in their emotional distress and suicidality could be detected during the course of the telephone session. Men, the elderly, and people living outside northern Taiwan, however, were less likely to call the NSPH. An unexpected yet significant finding is that people with an ongoing suicide attempt were less emotionally distressed than those with only suicidal thoughts.ConclusionsThe hotline is a useful suicide preventive and crisis intervention service. However, further creative and consistent work is needed to make the service more appealing to the hard-to-reach population.
       
  • Cortical biometals: Changed levels in suicide and with mood disorders
    • Abstract: Publication date: 15 January 2019Source: Journal of Affective Disorders, Volume 243Author(s): Brian Dean, Linh Q. Lam, Elizabeth Scarr, James A. Duce BackgroundChanges in levels of metals have been suggested to contribute to the pathophysiologies of several neurodegenerative disorders but to our knowledge this is the first metallomic study in CNS from patients with mood disorders. The focus of this study was on cortical regions affected by the pathophysiologies of bipolar disorders and major depressive disorders.MethodsLevels of metals were measured using inductively coupled plasma mass spectrometry in Brodmann's areas (BA) 6, 10 and 17 from patients with major depressive disorders (n = 13), bipolar disorders (n = 12) and age / sex matched controls (n = 13).ResultsThere were lower levels of cortical strontium (BA 6 & 10), ruthenium (BA 6 & 17) and cadmium (BA 10) from patients with major depressive disorder as well as lower levels of strontium in BA 10 from patients with bipolar disorders. Unexpectedly, there were changes in levels of 16 metals in the cortex, mainly BA 6, from suicide completers compared to those who died of other causes.LimitationsCohort sizes were relatively small but comparable with many studies using human postmortem CNS. Like all studies on non-treatment naïve patients, drug treatment was a potential confound in our experiments.ConclusionsOur exploratory study suggests changes in levels of metals in bipolar disorders and major depressive disorders could be affecting cortical oxidative balance in patients with mood disorders. Our data raises the possibility that measuring levels of specific biometals in the blood could be used as a biomarker for increased risk of suicide.
       
  • Symptoms of social anxiety disorder and major depressive disorder: A
           network perspective
    • Abstract: Publication date: 15 January 2019Source: Journal of Affective Disorders, Volume 243Author(s): Julia K. Langer, Natasha A. Tonge, Marilyn Piccirillo, Thomas L. Rodebaugh, Renee J. Thompson, Ian H. Gotlib BackgroundWe used network analyses to examine symptoms that may play a role in the co-occurrence of social anxiety disorder (SAD) and major depressive disorder (MDD). Whereas latent variable models examine relations among latent constructs, network analyses have the advantage of characterizing direct relations among the symptoms themselves.MethodWe conducted network modeling on symptoms of social anxiety and depression in a clinical sample of 130 women who met criteria for SAD, MDD, both disorders, or had no lifetime history of mental illness.ResultsIn the resulting network, the core symptoms of social fear and depressed mood appeared at opposite ends of the network and were weakly related; so-called “bridges” between these symptoms appeared to occur via intervening variables. In particular, the worthless variable appeared to play a central role in the network.LimitationsBecause our data were cross-sectional, we are unable to draw conclusions about the direction of these effects or whether these variables are related to each other prospectively.ConclusionsContinued testing of these pathways using longitudinal data will help facilitate the development of more effective clinical interventions for these disorders.
       
  • Executive dysfunctions and behavioral changes in early drug-naïve
           patients with Parkinson's disease
    • Abstract: Publication date: 15 January 2019Source: Journal of Affective Disorders, Volume 243Author(s): Shirong Li, Ruwei Ou, Xiaoqin Yuan, Hui Liu, Yanbing Hou, Qianqian Wei, Wei Song, Bei Cao, Yongping Chen, Huifang Shang ObjectivesThis study aims to explore the clinical profiles and onset age-related difference of executive dysfunctions and behavioral changes in early drug-naïve patients with Parkinson's disease (PD).MethodsA cross-sectional analysis on 419 early stage drug-naïve PD patients was conducted. The frontal assessment battery (FAB) was used to assess executive functions and the frontal behavioral inventory (FBI) was used to assess behavioral changes.ResultsExecutive dysfunctions were detected in 113 patients (27.0%), and 219 patients (52.3%) displayed varied degrees of behavioral changes. The most frequent affected domain for the FAB was lexical fluency (31.7%), while the three most frequent affected domains for the FBI were apathy (26.0%), irritability (24.3%) and inattention (20.8%). Compared to the early-onset PD (EOPD) patients, the late-onset PD (LOPD) patients exhibited significantly higher frequent damage in FAB especially similarities, motor series, and conflicting instructions as well as lower frequent damage in lexical fluency. The frequencies of FBI-abnormal were not different between the two groups. Multivariate analyses indicated that age at PD onset was independently associated with FAB total score and its subscores including lexical fluency, motor series, conflicting instructions and go-no go task, but it has no relationship with FBI total score and its subscores.ConclusionsExecutive deficits and behavioral changes are common in the early stage of PD. Age at PD onset is independently associated with the performance of executive functions. However, behavioral changes in PD may be not affected by onset age.
       
  • Subjective and physiological response to emotions in temporal lobe
           epilepsy and psychogenic non-epileptic seizures
    • Abstract: Publication date: Available online 5 October 2018Source: Journal of Affective DisordersAuthor(s): Iliana Kotwas, Jean-Arthur Micoulaud-Franchi, Stéphanie Khalfa, Aileen McGonigal, Mireille Bastien-Toniazzo, Fabrice Bartolomei Background: Temporal lobe epilepsy (TLE) and psychogenic non-epileptic seizures (PNES) are conditions frequently associated with dysfunction in emotional regulation leading to increased risk of affective disorders. This study investigates emotional processing with an objective measure of emotional reactivity in patients with TLE and patients with PNES.Methods: 34 patients with TLE and 14 patients with PNES were evaluated on skin conductance responses (SCR) to emotions induced by short films and compared to 34 healthy controls. An attention and a suppression condition were performed while viewing the films.Results: The both groups of patients disclosed lower SCR to emotions compared to controls, mainly in suppression condition. While TLE patients had lower SCR in attention condition than controls for fear, sadness and happiness, PNES had lower SCR only for happiness. In suppression condition, both had lower SCR than controls except for peacefulness in both groups and sadness in PNES. Subjective evaluations revealed that both patient's groups scored a higher intensity for sadness than controls in attention and lower for in fear and disgust in suppression only in TLE.Limitations: The sample size in the PNES group and the lack of a control group with similar levels of mood symptoms limited the interpretation of our results.Conclusion: As no correlation were found between SCR to emotions and scores of affective disorders, this pattern of responses might be underpinned by specific pathophysiological and cognitive mechanisms related to TLE and to PNES. Thus, therapeutic approaches targeting emotional autonomic responses can be of interest in the management of these conditions.
       
  • Diet and physical activity in the association between depression and
           metabolic syndrome: Constances study
    • Abstract: Publication date: Available online 27 September 2018Source: Journal of Affective DisordersAuthor(s): Joane Matta, Nicolas Hoertel, Emmanuelle Kesse-Guyot, Marie Plesz, Emmanuel Wiernik, Claire Carette, Sébastien Czernichow, Frédéric Limosin, Marcel Goldberg, Marie Zins, Cédric Lemogne BackgroundThe association between depression and the metabolic syndrome remains poorly understood. Diet and physical activity may partly explain this association.MethodsBaseline data on 64861 subjects from the French population-based Constances cohort was analyzed. Depressive symptoms were determined with the Center of Epidemiologic Studies Depression (CES-D) scale. A CES-D score ≥ 19 combined with self-reported limitations related to depressive symptoms was used to define depression. The metabolic syndrome was defined according to the International Diabetes Federation criteria. Dietary patterns were determined with a food frequency questionnaire and a principal component analysis. Physical activity was measured with 3 questions resulting in a composite 6-point scale. Associations between depression and the metabolic syndrome were estimated through logistic regression and path analysis.ResultsThe odds-ratios (95% confidence interval) for the association between depression and the metabolic syndrome, adjusting for age, sex, education and income, was 1.75 (1.57-1.96). The path analysis showed that 23% of this association was explained by diet and physical activity, 67% being attributed to physical activity.LimitationsThe cross-sectional nature of the analyses warrants the results to be confirmed by longitudinal analyses.ConclusionDiet and physical activity might partially explain the association between depressive symptoms and metabolic syndrome but other factors (e.g. inflammatory factors) are involved.
       
  • The relationship between visceral adiposity and depressive symptoms in the
           general Korean population
    • Abstract: Publication date: Available online 17 September 2018Source: Journal of Affective DisordersAuthor(s): Sung Joon Cho, Hyun Jeong Lee, Sang Jin Rhee, Eun Young Kim, Kyoung-Nam Kim, Dae Hyun Yoon, Yong Min Ahn BackgroundIn Korea, depressive symptoms or depression are prevalent. Metabolic syndrome is the representative medical condition associated with depression. This study examined the association between clinically significant depressive symptoms and intra-abdominal fat, measured using abdominal computed tomography, in a large sample of the Korean population who underwent routine health examination.MethodsPeople who underwent routine health examinations at the Seoul National University Hospital Healthcare System, Gangnam Center, from October 2004 to July 2012 were included in the study. There were 11,434 cases of individuals with CT scan data and entries in the Beck Depression Inventory (BDI). Of these, 1,156 men and women underwent CT scans more than once. In these cases, we analyzed the first scan.ResultsWe analyzed 4,945 male and 2,293 female participants; 333 participants (171 male, 162 female) were in the clinically depressed group. After controlling for confounding factors, we found that clinically depressive symptoms were associated with visceral adiposity in women. Per 1 cm2 of visceral adipose tissue area, the risk of being clinically depressed increased 1.006-fold. Similarly, per 1% increase in the ratio of visceral and total adipose tissue area in women, the risk increased 1.028-fold.ConclusionsOur large-sample study showed depressive symptoms are associated with intra-abdominal fat and the ratio of visceral and total adipose area in women, after controlling for confounding factors including BMI, hypertension, and diabetes.
       
  • The impact of COMT polymorphisms on cognition in Bipolar Disorder: A
           review: Special Section on “Translational and Neuroscience Studies in
           Affective Disorders” Section Editor, Maria Nobile MD, PhD. This Section
           of JAD focuses on the relevance of translational and neuroscience studies
           in providing a better understanding of the neural basis of affective
           disorders. The main aim is to briefly summaries relevant research findings
           in clinical neuroscience with particular regards to specific innovative
           topics in mood and anxiety disorders
    • Abstract: Publication date: Available online 8 August 2018Source: Journal of Affective DisordersAuthor(s): A. Pigoni, M. Lazzaretti, G.M. Mandolini, G. Delvecchio, A.C. Altamura, J.C. Soares, P. Brambilla BackgroundCognitive deficits represent a core feature of Bipolar Disorder. The dopamine system is considered fundamental for cognitive functions relying on prefrontal cortex, such as attention and executive functions. A genetic regulation of prefrontal dopamine has been described and the catechol-O-methyltransferase (COMT) has been extensively studied in relation to numerous psychiatric phenotypes, especially because of the involvement of its polymorphisms in the regulation of cognitive functions. Specifically, the Val158Met polymorphism greatly alters COMT function and cognitive performance in both psychiatric disorders and healthy controls. However, only few studies assessed the association between COMT polymorphisms and cognitive functions in bipolar disorder (BD) subjects and this association might help in the comprehension of cognitive alterations in BD.MethodsIn this context, the present review summarizes results from genetic studies that investigated COMT genetic modulation on cognitive performance in patients affected by BD.ResultsOverall the results confirmed that (a) COMT Val158Met polymorphism is associated with altered cognitive functions in BD patients, especially in the domains of memory, executive functions and emotion detection; and (b) COMT genotype may interact with both mood episodes and pharmacologic treatments in determining the cognitive profile of these subjects.LimitationsFew genetic studies exploring COMT genetic effect on cognition in BD.ConclusionsThese findings seem to indicate a role of COMT polymorphisms in regulating cognitive functioning in patients with BD. The genetically determined dopaminergic tone may be further affected by mood episodes and pharmacological treatments.
       
  • The impact of BDNF Val66Met polymorphism on cognition in Bipolar Disorder:
           A review: Special Section on “Translational and Neuroscience Studies in
           Affective Disorders” Section Editor, Maria Nobile MD, PhD. This Section
           of JAD focuses on the relevance of translational and neuroscience studies
           in providing a better understanding of the neural basis of affective
           disorders. The main aim is to briefly summaries relevant research findings
           in clinical neuroscience with particular regards to specific innovative
           topics in mood and anxiety disorders
    • Abstract: Publication date: Available online 24 July 2018Source: Journal of Affective DisordersAuthor(s): G.M. Mandolini, M. Lazzaretti, A. Pigoni, G. Delvecchio, J.C. Soares, P. Brambilla BackgroundConverging lines of evidence suggest that Brain-Derived Neurotrophic Factor (BDNF) may play a central role in the pathogenesis of Bipolar Disorder (BD), thus representing a valid biomarker of the disease. A common genetic variation in the BDNF gene, the Val66Met, is associated with reduced maturation and secretion of BDNF and therefore it has been related to specific mood, cognitive and neuroanatomical alterations in BD. However, so far, only a handful of studies have investigated the association between Val66Met polymorphism and cognitive functioning in BD.MethodsWe performed a bibliographic search on PUBMED of all genetic studies investigating Val66Met modulation on cognitive performances in BD subjects. The inclusion criteria were met by nine studies, including a total amount of 897 BD subjects and 803 healthy controls.ResultsFrom the analysis of the existing literature emerged that a) Val allele in BD adults, but not in BD adolescents, was associated with better performances in selective cognitive domains including executive functions, verbal learning and memory; b) Met allele may negatively modulate the association between childhood trauma and performances in memory, verbal ability and verbal fluency tasks; c) Met allele may also negatively regulate structural abnormalities in cognitive cerebral structures; d) Val/Met carriers showed greater improvements in cognitive functions compared to Val/Val and Met/Met carriers.LimitationsFew genetic studies exploring the impact of Val66Met on cognition in BD.ConclusionsVal66Met polymorphism likely modulates cognitive functions in BD patients with complex gene-environment interactions and through potential modulations of cerebral structures. Further and larger genetic studies are required in order to detect association between BDNF polymorphism, BDNF levels, brain abnormalities and cognition in BD.
       
  • Repeat-dose ketamine augmentation for treatment-resistant depression with
           chronic suicidal ideation: A randomized, double blind, placebo controlled
           trial
    • Abstract: Publication date: 15 January 2019Source: Journal of Affective Disorders, Volume 243Author(s): Dawn F. Ionescu, Kate H. Bentley, Matthias Eikermann, Norman Taylor, Oluwaseun Johnson-Akeju, Michaela B. Swee, Kara J. Pavone, Samuel R. Petrie, Christina Dording, David Mischoulon, Jonathan E. Alpert, Emery N. Brown, Lee Baer, Matthew K. Nock, Maurizio Fava, Cristina Cusin BackgroundSeveral studies indicate that ketamine has rapid antidepressant effects in patients with treatment-resistant depression (TRD). The extent to which repeated doses of ketamine (versus placebo) reduce depression in the short and long term among outpatients with TRD and chronic, current suicidal ideation remains unknown.MethodsTwenty-six medicated outpatients with severe major depressive disorder with current, chronic suicidal ideation were randomized in a double-blind fashion to six ketamine infusions (0.5 mg/kg over 45 minutes) or saline placebo over three weeks. Depression and suicidal ideation were assessed at baseline, 240 min post-infusion, and during a three-month follow-up phase.ResultsDuring the infusion phase, there was no differences in depression severity or suicidal ideation between placebo and ketamine (p = 0.47 and p = 0.32, respectively). At the end of the infusion phase, two patients in the ketamine group and one in the placebo group met criteria for remission of depression. At three-month follow-up, two patients in each group met criteria for remission from depression.LimitationsLimitations include the small sample size, uncontrolled outpatient medication regimens, and restriction to outpatients, which may have resulted in lower levels of suicidal ideation than would be seen in emergency or inpatient settings.ConclusionsRepeated, non-escalating doses of ketamine did not outperform placebo in this double-blind, placebo controlled study of patients with severe TRD and current, chronic suicidal ideation. This result may support our previously published open-label data that, in this severely and chronically ill outpatient population, the commonly used dose of 0.5 mg/kg is not sufficient.
       
  • Temperament traits and remission of depression: A naturalistic six-month
           longitudinal study
    • Abstract: Publication date: 15 January 2019Source: Journal of Affective Disorders, Volume 243Author(s): David Gurpegui, Felipe Ortuño, Manuel Gurpegui BackgroundThe aim of this naturalistic longitudinal study was to add evidence regarding the potential of Cloninger's temperament traits (novelty seeking, harm avoidance, reward dependence and persistence) for predicting the effect of pharmacological treatment on the rates of therapeutic response and remission.MethodsThe study was based on 200 outpatients with unipolar depressive disorders of different severity and course of illness, and extended up to 6 months of follow-up. Patients were assessed in their temperament with the Tridimensional Personality Questionnaire (TPQ) and their condition was classified (in course and severity) according to the International Classification of Diseases, Tenth revision (ICD-10) diagnostic criteria for research. Patients were blindly rated (concerning other predicting variables) on the improved Clinical Global Impression–Severity scale for depression (iCGI-S) at baseline, 6 weeks, 3 months and 6 months. Outcome measures at the last observation carried forward were therapeutic response (reduction of ≥50% in the last iCGI-S) and remission (last iCGI-S = 0), which were available for 187 patients.ResultsRemission was independently and directly associated with length of follow-up, and inversely with the baseline iCGI-S score and harm avoidance (patients in the high tertile had a 2.7 likelihood of non-remission in comparison with those in the low tertile); persistence was found to have a complex, V-shape relationship with remission. Within a sub-sample of more severe cases (n = 118), having higher harm avoidance scores, a more favorable outcome was associated with higher reward dependence and the non-smoking condition.LimitationsWith a naturalistic, non-experimental design, the sample may not be representative of the general population.ConclusionsTemperament traits may help predict outcome in patients treated for depression.
       
  • Handgrip strength and depression among 34,129 adults aged 50 years and
           older in six low- and middle-income countries
    • Abstract: Publication date: 15 January 2019Source: Journal of Affective Disorders, Volume 243Author(s): Garcia Ashdown-Franks, Brendon Stubbs, Ai Koyanagi, Felipe Schuch, Joseph Firth, Nicola Veronese, Davy Vancampfort IntroductionHandgrip strength is a simple and inexpensive marker of health and mortality risk. It presents an ideal risk-stratifying method for use in low and middle-income countries (LMICs). There are, however, no population-based studies investigating the associations between handgrip strength and depression in LMICs. We aimed to assess these associations among community-dwelling middle-aged and older adults using nationally representative data from six LMICs.MethodCross-sectional data on individuals aged ≥ 50 years from the World Health Organization's Study on Global Ageing and Adult Health were analyzed. Depression was based on the Composite International Diagnostic Interview. Weak handgrip strength was defined as 
       
  • Impulsive suicide attempts among young people–A prospective
           multicentre cohort study in Sweden
    • Abstract: Publication date: 15 January 2019Source: Journal of Affective Disorders, Volume 243Author(s): K. Beckman, A.U. Lindh, M. Waern, L. Stromsten, E.S. Renberg, B. Runeson, M. Dahlin BackgroundWe aimed to compare the prevalence of impulsive suicide attempts (ISA) among young adults and those over 25 who present at hospital in connection with attempted suicide. We also aimed to identify factors associated with ISA in young adults and to assess medical severity as well as the probability of repeated suicide attempts in this age group.MethodA prospective multicentre cohort study included hospital known cases of suicide attempt (N = 666). The prevalence of ISA was compared between young adults (18–25) and adults aged > 26. We used logistic regression models to identify factors associated with ISA, associations of ISA with high medical severity and prediction of new fatal or non-fatal suicide attempts within 6 months.Results43.7% of the young patients had made an ISA, and 30.2% among those aged > 26 (p = 0.001). Among the young, substance use disorder was associated with ISA; crude odds ratio (OR) 2.0 (1.0–4.2), and adjusted OR 2.1 (0.99–4.4). Affective disorder and unemployment/ sickness absence implied lower odds of ISA. ISA resulted in injuries of high medical severity as often as more planned attempts and non-fatal or fatal repetition within 6 months was equally common (30%) in both groups.LimitationsThe study was set in psychiatric emergency services, which limits the generalizability.ConclusionsClinicians should acknowledge that suicide attempts among youth often occur without previous planning and may result in medically severe injuries. The probability of new fatal or non-fatal suicide attempts should be kept in mind also after an impulsive suicide attempt.
       
  • Cardiovascular comorbidity increases the risk for renal failure during
           prophylactic lithium treatment
    • Abstract: Publication date: 15 January 2019Source: Journal of Affective Disorders, Volume 243Author(s): Harald Aiff, Per-Ola Attman, Bernd Ramsauer, Staffan Schön, Jan Svedlund BackgroundThe development of lithium-associated kidney damage is still a matter of controversy. We have addressed this question by investigating the role of somatic comorbidity for developing kidney failure in lithium treated patients.MethodsThe study group comprised of 1741 adult patients with normal creatinine levels at the start of lithium treatment. Patients who developed severe renal failure (CKD stages 4–5, n = 109), were matched by sex, time on lithium and age at start of lithium, with 109 controls (CKD stages 1–2) that did not develop severe renal failure.ResultsPatients in CKD 4–5 did not differ significantly from controls (CKD 1–2) in sex (females/males were 76/33 in both groups), time on lithium (mean 9.8 years, SD 6.4; vs. 9.6, SD 6.2) or age at start of lithium (mean 61.6 years, SD 13.4; vs. 60.5 years, SD 12.3), respectively. However, comparisons between groups showed a significantly higher prevalence of somatic comorbidity (p 
       
  • The prevalence of moderate-to-high posttraumatic growth: A systematic
           review and meta-analysis
    • Abstract: Publication date: 15 January 2019Source: Journal of Affective Disorders, Volume 243Author(s): Xiaoli Wu, Atipatsa C Kaminga, Wenjie Dai, Jing Deng, Zhipeng Wang, Xiongfeng Pan, Aizhong Liu BackgroundPosttraumatic growth (PTG) is positive psychological changes after encountering challenging events. The main purpose of this meta-analysis was to summarize the prevalence of moderate-to-high PTG in people who experienced traumatic events and to understand what social-demographic and trauma characteristics distinguish those who show a high rate of PTG from those of low level.MethodsSix electronic databases were searched. Loney's appraisal criteria were used to evaluate the quality of studies. Freeman-Turkey double arcsine transformation method was used to calculate the combined prevalence. Age, time since event, type of trauma and trauma form were analyzed as subgroup factors. According to the source of the trauma, the type of trauma was divided into three different categories: disease, accident and specific profession. Specific profession refers to firefighters, veterans, intensive care staff, etc. The complex working environment, irregular lifestyle, various unpredictable factors, as well as the frequently adverse stimuli from others contribute to great physical and mental pressure.ResultsTwenty-six articles were deemed as qualified for this systematic review and meta-analysis. The level of PTG across studies ranged from 10% to 77.3%, and heterogeneity tests showed high heterogeneity (I2 = 92.3%, 95%CI = 90.1%-94.0%, p 
       
  • Lack of emotional clarity and diminished self-efficacy as core problems in
           functional dependency: A structural equation modeling analysis with a
           college student sample
    • Abstract: Publication date: 15 January 2019Source: Journal of Affective Disorders, Volume 243Author(s): Andrew S. McClintock, Shannon M. McCarrick BackgroundHigh levels of functional dependency appear to be deleterious to psychological and physical health. The goal of this research was to identify factors responsible for the association between functional dependency and negative health outcomes.MethodsSelf-report data were collected from 149 undergraduate students. Structural equation modeling was used to test a model in which functional dependency has indirect effects on three negative psychological outcomes (negative affect, functional impairment, and dissatisfaction with life) through two variables: lack of experiential awareness and diminished self-efficacy.ResultsThe model provided a good fit to the data and five of the six indirect effects were statistically significant.LimitationsLimitations include self-report and cross-sectional nature of the data.ConclusionsThese results help to shed light on the core pathology in functional dependency and implicate specific interventions in treating problems associated with this personality trait.
       
  • How many bereaved people hallucinate about their loved one' A
           systematic review and meta-analysis of bereavement hallucinations
    • Abstract: Publication date: 15 January 2019Source: Journal of Affective Disorders, Volume 243Author(s): Karina Stengaard Kamp, Helena Due BackgroundBereavement hallucinations (BHs) entail a perception of a deceased in any sense modality or as a quasi-sensory sense of presence. BHs are an associated feature of the proposed Persistent Complex Bereavement Disorder (PCBD) in DSM-5. The goals of this review are to estimate the prevalence of BHs, identify possible moderators, and review the methodological status of this research field.MethodsA systematic literature search was conducted through the databases PubMed, PsycINFO, and CINAHL. Studies systematically assessing the prevalence of BHs of a relative or friend were included.ResultsTwenty-one eligible studies were identified and 8 meta-analyses of BHs in different sense modalities were conducted. The prevalence of having one or more BHs was estimated to be 56.6% (95% CI 49.9–63.2), and the estimated prevalence of BHs in specific sense modalities ranged within 7.0–39.7%. Meta-regression analyses revealed associations to age and conjugal bereavement, but results are tentative and dependent on the type of BH in question.LimitationsThe included studies were methodologically heterogeneous. Limitations included the lack of a valid measure of BHs and low sample generalizability.ConclusionThis first systematic review and meta-analysis of BHs suggests that more than half of the bereaved people experience some kind of BH. However, there are considerable methodological limitations in the research of BHs, which is of pertinent interest as BHs have been linked to the development of a future diagnosis of clinically impairing grief. A valid measure of BHs needs to be developed and used in high-quality epidemiological research using population-based designs.
       
  • Aberrant cortical neurodevelopment in major depressive disorder
    • Abstract: Publication date: 15 January 2019Source: Journal of Affective Disorders, Volume 243Author(s): Mike M. Schmitgen, Malte S. Depping, Claudia Bach, Nadine D. Wolf, Katharina M. Kubera, Nenad Vasic, Dusan Hirjak, Fabio Sambataro, Robert C. Wolf BackgroundThere is strong neuroimaging evidence that cortical alterations represent a core pathophysiological feature of major depressive disorder (MDD). Differential contributions of cortical features of neurodevelopmental origin, which may distinctly contribute to MDD vulnerability, disease-onset, or symptom expression, are unclear at present.MethodsWe investigated distinct markers of cortical neurodevelopment, i.e. local cortical gyrification (LGI) and thickness (CT) in patients with MDD (n = 38) and healthy controls (HC, n = 22) using 3 T structural magnetic resonance imaging data and surface-based data analysis techniques. CT and LGI were computed using the Computational Anatomy Toolbox (CAT12). Analyses were performed for the entire cortical surface followed by a complementary regions-of-interest approach.ResultsMDD patients showed significantly greater LGI in frontal, cingulate, parietal, temporal, and occipital regions compared to HC (FDR-corrected at p 
       
  • Gender inequality and suicide gender ratios in the world
    • Abstract: Publication date: 15 January 2019Source: Journal of Affective Disorders, Volume 243Author(s): Qingsong Chang, Paul S.F. Yip, Ying-Yeh Chen BackgroundTo assess whether gender inequality determines the patterns of suicide gender ratios.MethodsUsing suicide data obtained from the World Health Organization Statistical Information System, 2012, suicide gender ratios were calculated and a world map of the ratios constructed. Forest plots were utilized to assess whether gender inequality (indicated by the Gender Inequality Index [“GII”] and male to female sex ratios at birth) moderated the worldwide patterns of suicide gender ratios. Regression analyses were then performed to estimate the extent to which gender inequality affects suicide gender ratios before and after controlling for human development level (“HDI”).ResultsGradient relationships of suicide gender ratios across 3 tertiles of GII were observed (ratios = 2.03, 2.54, 3.51, respectively for high, moderate and low GII, P = 0.03). High sex ratio at birth was significantly associated with lower suicide gender ratio (ratio = 1.64 vs. 2.75, P = 0.00). Regression analyses showed that highest tertile of GII and high sex ratios at birth were significantly associated with lower suicide gender ratios (P = 0.00 and P = 0.00, respectively). When the level of human development level was controlled, high sex ratio at birth remained to be a significant determinant of suicide gender ratios (P = 0.00), whereas the significance of GII disappeared (P = 0.19).LimitationsThe cross-sectional data do not allow for causal inferences.ConclusionsMale to female suicide ratios were higher in countries with more egalitarian gender norms. Strategies to eliminate culturally embedded gender discrimination have the potentials to prevent suicides.
       
  • The association of vision loss and dimensions of depression over 12 years
           in older adults: findings from the Three City Study
    • Abstract: Publication date: Available online 22 September 2018Source: Journal of Affective DisordersAuthor(s): S Cosh, I Carriere, V Nael, C Tzourio, C Delcourt, C Helmer, the Sense-Cog Consortium¥ BackgroundThe established relationship between vision impairment and depression is limited by the examination of depression only as a unidimensional construct. The present study explores the vision-depression relationship using a dimensional approach.Methods9036 participants aged 65 years and above enrolled in the Three-City study were included. Relationships between baseline near Vision Impairment (VI) or self-reported distance Visual Function (VF) loss with trajectory of four dimensions of depression – depressed affect, positive affect, somatic symptoms and interpersonal problems - over 12 years were examined using mixed-effects models. Depression dimensions were determined using the four-factor structure of the Centre for Epidemiology Studies-Depression Scale (CESD).ResultsIn the fully adjustment models, mild near VI predicted poorer depressed affect (b= 0.04, p = .002) and positive affect (b = -0.06, p
       
  • Abnormal cerebellum-DMN regions connectivity in unmedicated bipolar II
           disorder
    • Abstract: Publication date: Available online 21 September 2018Source: Journal of Affective DisordersAuthor(s): Guanmao Chen, Lianping Zhao, Yanbin Jia, Shuming Zhong, Feng Chen, Xiaomei Luo, Shaojuan Qiu, Shunkai Lai, Zhangzhang Qi, Li Huang, Ying Wang ObjectiveBipolar disorder (BD) is a common psychiatric disease. Previous studies have found abnormalities in structural and functional brain connectivity in BD patients. However, few studies have focused on the functional connectivity (FC) of the cerebellum and its sub-regions in patients with BD. The present study aimed to examine the FC of cerebellum-default mode network (DMN) regions in patients with BD II.MethodNinety patients with unmedicated BD II depression and 100 healthy controls (HCs) underwent resting-state functional magnetic resonance imaging. We selected three pairs of subregions of the cerebellum that are DMN-related (the bilateral Crus I, Crus II, and lobule IX) as seed regions and calculated the whole brain FC for each subregion.ResultsCompared with the HCs, the patients with BD II depression showed increased connectivity between the right Crus I and bilateral precuneus and decreased connectivity between the left Crus II and bilateral medial prefrontal cortex (mPFC) and between the left Crus II and right medial frontal gyrus (MFG). There was no significant difference in the whole FC of the left Crus I and bilateral lobule IX between the BD II depression group and the HCs group.LimitationsThis study was cross-sectional and did not examine data from euthymic BD patients.ConclusionsThe findings showed impaired FC of cerebellum-DMN regions in BD; partial FC between the Crus I and precuneus and the Crus II and prefrontal cortex suggests the importance of abnormal cerebellum-DMN regions FC in the pathophysiology of BD.
       
  • A randomized controlled trial of ‘MUMentum Pregnancy’:
           Internet-delivered cognitive behavioral therapy program for antenatal
           anxiety and depression
    • Abstract: Publication date: Available online 21 September 2018Source: Journal of Affective DisordersAuthor(s): Siobhan A. Loughnan, Amanda Sie, Megan J. Hobbs, Amy E. Joubert, Jessica Smith, Hila Haskelberg, Alison E.J. Mahoney, Natalie Kladnitski, Christopher J. Holt, Jeannette Milgrom, Marie-Paule Austin, Gavin Andrews, Jill M Newby BackgroundAnxiety and depression are common during pregnancy and associated with adverse outcomes for the mother and infant if left untreated. Despite the need to improve treatment accessibility and uptake in this population, no studies have investigated internet-delivered cognitive behavioural therapy (iCBT) for antenatal anxiety and depression. In a randomized controlled trial, we examined the efficacy and acceptability of a brief, unguided iCBT intervention – the MUMentum Pregnancy program – in pregnant women with anxiety and/or depression.MethodsParticipants meeting clinical threshold on validated self-report measures of generalized anxiety and/or depression were recruited online and randomized to iCBT (n = 43) or a treatment as usual (TAU) control (n = 44). Outcomes were assessed at baseline, post-treatment and four-week follow-up; and included anxiety, depression, psychological distress, antenatal bonding, quality of life, and treatment acceptability.ResultsOf the 36 women who started iCBT, 26 completed all three lessons of treatment (76% adherence rate). iCBT produced moderate to large effect size reductions for anxiety on the GAD-7 (Hedges’ g = 0.76) and psychological distress on the Kessler-10 (g = 0.88) that were superior to TAU. Only small nonsignificant differences were found for depression outcomes (g = 
       
  • The burden of depression in systemic sclerosis patients: insights from a
           real-world big data-based analysis
    • Abstract: Publication date: Available online 21 September 2018Source: Journal of Affective DisordersAuthor(s): Nicola L. Bragazzi, Abdulla Watad, Alexander Gizunterman, Dennis McGonagle, Hussein Mahagna, Doron Comaneshter, Howard Amital, Arnon D. Cohen, Daniela Amital BackgroundSystemic sclerosis (SSc) can clinically present with psychological symptoms, including pain, depression, and distress about disfigurement, physical and social functioning. The existing small studies have reported a prevalence of depression ranging from 36% to 65% among SSc patients, likely reflecting the disease impact on the patient's self-image and function.Aim of the studyTo investigate the association between SSc and depression using big data analysis methods.MethodsWe designed a nation-wide epidemiological survey relying on a large database of 2500 SSc patients and explored the relationship between SSc and depression, but also the impact of depression on the survial of SSc patients. Chi-squared and t-tests were used for univariate analysis and a logistic regression model was used for multivariate analysis.ResultsThe proportion rate of depression among SSc patients was significantly higher than controls (16.2% vs 10.9%), and this proportion was even higher in female SSc patients and of low socioeconomic status. At the multivariate logistic regression, SSc was found to be an independent risk factor for depression with an OR of 1.55 (95%CI 1.29-1.88, p
       
  • GxE effects of FKBP5 and traumatic life events on PTSD: A
           meta-analysis
    • Abstract: Publication date: Available online 21 September 2018Source: Journal of Affective DisordersAuthor(s): Sage E. Hawn, Christina M. Sheerin, Mackenzie J. Lind, Terrell A. Hicks, Marisa E. Marraccini, Kaitlin Bountress, Silviu-Alin Bacanu, Nicole R. Nugent, Ananda B. Amstadter BackgroundTwin studies have demonstrated that both genetic and environmental factors influence risk for posttraumatic stress disorder (PTSD), and there is some evidence supporting the interplay of genes and environment (GxE). Many GxE studies within the PTSD literature have focused on genes implicated in the stress response system, such as FK506 binding protein 51 (FKBP5). Given inconsistencies across GxE literature as a whole, a meta-analysis to synthesize results is warranted.MethodsStudies were identified through PubMed and PsycINFO. A meta-analysis was conducted using a random effects model in the MAc package in R. Heterogeneity of the effect size distribution was examined with Cochran's Q statistic. A Simes procedure was used to test the gene-level GxE effect for FKBP5 interacting with trauma.ResultsA significant gene-level GxE gene effect was demonstrated for FKBP5 when pooled across all four examined variants (rs1360780, rs3800373, rs9296158, rs9470080) when interacting with trauma exposure on PTSD. Significant large GxE effect sizes were also found for each independent variant. There was no evidence for heterogeneity of variance.LimitationsLimitations include reduced power for detecting variability across moderators, potential bias due to failure of meta-analyzed studies to account for two-way covariate x gene and covariate x environment influences, and a high false discovery rate that is characteristic of GxE analyses.ConclusionsThis is the first study to quantify an overall gene-level effect of FKBP5 in a GxE analysis of PTSD, evidence which may be used to address current issues in the FKBP5 GxE literature (e.g., disparate variants, low sample sizes and power), as well as inform follow-up functional research.
       
  • Self-disgust as a potential mechanism explaining the association between
           loneliness and depression
    • Abstract: Publication date: 15 January 2019Source: Journal of Affective Disorders, Volume 243Author(s): Antonia Ypsilanti, Lambros Lazuras, Phillip Powell, Paul Overton BackgroundLoneliness and self-disgust have been considered as independent predictors of depressive symptoms. In the present study, we hypothesized that self-disgust can explain the association between loneliness and depression, and that emotion regulation strategies interact with self-disgust in predicting depressive symptoms.MethodsThree hundred and seventeen participants (M = 29.29 years, SD = 14.11; 76.9% females) completed structured anonymous self-reported measures of loneliness, self-disgust, emotion regulation strategies, and depressive symptoms.ResultsOne-way MANOVA showed that participants in the high-loneliness group reported significantly higher behavioural and physical self-disgust, compared to those in the middle and low-loneliness groups. Bootstrapped hierarchical linear regression analysis showed that self-disgust significantly improved predicted variance in depressive symptoms, after controlling for the effects of loneliness. Regression-based mediation modelling showed that both physical and behavioural self-disgust significantly mediated the association between loneliness and depression. Finally, moderated regression analysis showed that expressive suppression interacted with self-disgust in predicting depressive symptoms.LimitationsA cross-sectional design was used, and our study focused on expressive suppression and cognitive reappraisal but not on other aspects of emotion regulation or the modulation of emotional arousal and responses.ConclusionsWe demonstrated, for the first time, that self-disgust plays an important role in the association between loneliness and depressive symptoms. Furthermore, variations in emotion regulation strategies can explain the association between self-disgust and depressive symptoms.
       
  • Quality of life across domains among individuals with treatment-resistant
           depression
    • Abstract: Publication date: Available online 19 September 2018Source: Journal of Affective DisordersAuthor(s): Heidemarie Lex, Yarden Ginsburg, Adam F. Sitzmann, Clara Grayhack, Daniel F. Maixner, Brian J. Mickey BackgroundTreatment-resistant depression affects millions of people worldwide and is a leading cause of disability and suicide. Studies of treatment-resistant depression outcomes have traditionally focused on depressive symptoms and functional impairment. Quality of life (QoL) has not been well described. We aimed to measure QoL in individuals with treatment-resistant depression and to determine how QoL was related to traditional measures of symptoms and social functioning.MethodsWe used a reliable, cross-culturally validated questionnaire, the abbreviated World Health Organization Quality of Life scale (WHOQOL-BREF), to prospectively measure QoL in 79 patients with treatment-resistant depression who were referred for electroconvulsive therapy at a United States tertiary-care medical center. QoL was characterized in four domains: physical, psychological, social, and environmental. QoL domains were examined for association with demographic variables, patient-reported depressive symptoms, functional impairment, and childhood adversity, as well as clinician-rated scales.ResultsRelative to published international norms, mean QoL scores were low in physical (standardized score, z = –2.0), psychological (z = –2.6), and social (z = –1.0) domains, but not in the environmental domain (z = 0.2). After controlling for age and income, patient-rated depressive symptoms correlated with physical (Pearson correlation, r = –0.26) and psychological (r = –0.43) QoL, whereas adverse childhood experiences correlated with environmental QoL (r = –0.33). Patient-rated functional impairment correlated modestly with all domains (r = –0.25 to –0.39). Surprisingly, QoL correlated very weakly with clinician-rated measures. These modest associations of QoL with other clinical scales were confirmed in multiple regression analyses.LimitationsWe used a single QoL instrument, which did not allow us to directly compare the WHOQOL-BREF scale with other commonly used instruments. Our sample was recruited from a single academic medical center in the Midwest region of the United States and was largely Caucasian. These factors may limit generalizability to other settings and ethnicities.ConclusionAmong individuals with treatment-resistant depression, QoL is lowest in the psychological and physical domains. QoL is only modestly correlated with patient-rated symptoms and functioning, and even more weakly correlated with clinician-rated scales, indicating that measures of symptoms and functioning cannot serve as QoL proxies. QoL should be assessed when caring for patients with treatment-resistant depression. When developing novel biological, psychological, and social interventions for treatment-resistant depression, QoL should be targeted as a distinct clinical outcome.
       
  • Associations between broader autism phenotype (BAP) and maternal
           attachment are moderated by maternal postpartum depression when infants
           are one month old: A prospective study of the Japan Environment &
           Children's Study
    • Abstract: Publication date: Available online 19 September 2018Source: Journal of Affective DisordersAuthor(s): Kumi Hirokawa, Takashi Kimura, Satoyo Ikehara, Kaori Honjo, Takuyo Sato, Kimiko Ueda, Hiroyasu Iso, Japan Environment & Children's Study Group BackgroundBroader autism phenotype (BAP) refers to the expression of behavioral and cognitive dispositions similar to autism spectrum disorder. The present study investigated whether mothers’ BAP was prospectively associated with maternal attachment, and if postpartum depression modified this association.MethodsThe Japan Environment and Children's Study (JECS) is a national and government-funded birth cohort study that began in January 2011. Among the 103,099 mothers enrolled, 87,369 mothers without a history of depression were included in the analysis. Self-administered questionnaires were used. These included: the Japanese version of the Autism Spectrum Quotient, the Mother to Infant Bonding Scale, and the Edinburgh Postnatal Depression Scale. Logistic regression analyses were performed.ResultsThe BAP during the second or third trimester of pregnancy was linearly associated with an increased risk of postpartum depression and insecure maternal attachment when infants were one month old (p for trend < 0.001), after adjusting for confounding variables. When stratified by postpartum depression, among the BAP subscales, deficiencies in social skills and communication were associated with an increased risk of insecure maternal attachment in mothers without postpartum depression. The relationships between the BAP subscales and maternal attachment were attenuated among mothers with postpartum depression.LimitationsOnly five items of the Mother to Infant Bonding Scale were used in the present study, and thus the results should be interpreted with caution.ConclusionsMothers’ BAP was predictive of insecure maternal attachment toward their infant. Postpartum depression partially moderated the associations between mothers’ BAP and insecure maternal attachment.
       
  • Nonlinear dynamics of mood regulation in unaffected first-degree relatives
           of bipolar disorder patients
    • Abstract: Publication date: Available online 18 September 2018Source: Journal of Affective DisordersAuthor(s): Ortiz A, Bradler K, Garnham J, Slaney C, McLean S, Alda M BackgroundMood regulation is a complex and poorly understood process. In this study, we aimed to analyze the underlying dynamics of mood regulation in unaffected first degree relatives of patients diagnosed with bipolar disorder using time-series analysis.MethodsWe recruited 30 unaffected first-degree relatives of bipolar disorder patients. Participants rated their mood, anxiety and energy levels using a paper-based visual analog scale; they recorded their sleep and life events as well. Participants provided information on these variables over a three month period, twice per day. We compared their data using Box-Jenkins time series analysis with data from 30 healthy controls (HC) and 30 euthymic bipolar patients (BD) to obtain information on the autocorrelation and cross-correlation of the series, and calculated entropy for mood, anxiety and energy series.ResultsWe analyzed 14,980 data points: 5200 in the healthy control group; 4970 in the bipolar group and 4810 in the unaffected relatives group. There were no significant differences between groups in terms of age, sex or education levels. Using Kolmogorov-Smirnov test, we found that individual measures were normally distributed in the whole sample (D = 0.23, p> 0.1). Autocorrelation functions for mood in all groups are governed by the ARIMA (1,1,0) model, which means that current values in the series are related to one previous point only. In terms of entropy for the mood series, unaffected relatives and bipolar patients showed lower values [mean (SD) : 1.028 ± 0.679; 1.042 ± 0.680], respectively, compared to healthy controls [(1.476 ± 0.33); F (2,74) = 4.39, p < 0.01]. The same case was seen in the energy series, with lower values in the unaffected relatives and bipolar patient groups [mean (SD) : 1.644 ± 0.566; 1.511 ± 0.879], respectively, compared to healthy controls [2.230 ± 0.531; F(2, 75) = 7.89, p < 0.001].LimitationsLow resolution for the visual analog scale.ConclusionsUsing nonlinear analyses, we found that the underlying structure of mood regulation in unaffected relatives is undistinguishable from the one found in bipolar patients. Compared to healthy controls, both bipolar patients and their unaffected relatives showed lower entropy levels, which is in keeping with a more rigid system, not as flexible to cope with the demands of a changing environment.
       
  • Prevalence, risk factors and multi-group latent class analysis of lifetime
           anxiety disorders comorbid depressive symptoms
    • Abstract: Publication date: Available online 18 September 2018Source: Journal of Affective DisordersAuthor(s): Hongguang Chen, Xiao Wang, Yueqin Huang, Guohua Li, Zhaorui Liu, Yanxiang Li, Hongchun Geng BackgroundPrevious studies about comorbidity have primarily focused on disorders based on diagnostic criteria instead of symptoms. This study aimed to describe the prevalence and risk factors of anxiety comorbid depression based on a population-based sample in Chifeng City Inner Mongolia and explored the gender differences of depressive subtypes in anxiety patients.MethodsThis study was a cross-sectional study conducted among 6376 community residents. Logistics analysis and multiple-group latent class analysis was used in exploring the risk factors and subtypes of anxiety comorbid depressive symptoms.ResultsA total of 4,528 respondents were interviewed in this study. The lifetime prevalence estimates for anxiety in the total sample was 5.70%. Among residents who had ever had anxiety, most of them reported having depressive symptoms while 15.79% of them met the criteria of MDD. Logistics analysis showed childhood adversities were associated with anxiety comorbid depressive symptoms. The results of multiple-group latent class analysis showed that the latent class probabilities were different between males and females.ConclusionThe prevalence rates of comorbidity were similar to the reports of previous regional surveys in China with statistically significant differences of comorbidity occurring between males and females. Precision prevention should therefore be targeted towards different kinds of populations.
       
  • Bipolar Disorder and Psychotropic Medication: Impact on Pregnancy and
           Neonatal Outcomes
    • Abstract: Publication date: Available online 18 September 2018Source: Journal of Affective DisordersAuthor(s): Katherine L. Wisner, Dorothy Sit, Kelly O'Shea, Debra L. Bogen, Crystal T. Clark, Emily Pinheiro, Amy Yang, Jody D. Ciolino ObjectiveThe hypotheses were: 1) pregnant women with bipolar disorder (BD)have less favorable pregnancy outcomes than unaffected women, and 2) psychotropic treated women with BD have better outcomes than un-medicated women.MethodThis prospective study included 174 mother-infant dyads. Women had BD without psychotropic exposure (BD-NP, n=38), BD with psychotropic treatment (BD-P, n=49), or neither psychotropic exposure nor major mood disorder (Comp, n=87). Maternal characteristics were completed at 20 weeks gestation and evaluated for associations with delivery and birth outcomes. We performed multiple regressions on infant outcomes with adjustment for maternal age, race, employment status, use of illicit drugs and pre-pregnancy BMI.ResultsThe BP-P, BP-NP and Comp groups varied significantly on sociodemographic characteristics. Women with BD were more likely to be less educated, unemployed, single, and use tobacco and illicit drugs than women in the Comp group. Compared to women with BD-NP, women with BD-P were more likely to be older and educated.Approximately 10% of all infants were delivered preterm. No significant differences in outcome occurred for APGAR scores
       
  • Persistent depressive disorder has long-term negative impacts on
           depression, anxiety, and somatic symptoms at 10-year follow-up among
           patients with major depressive disorder
    • Abstract: Publication date: Available online 18 September 2018Source: Journal of Affective DisordersAuthor(s): Ching-I Hung, Chia-Yih Liu, Ching-Hui Yang ObjectiveThe study aimed to investigate the impacts of persistent depressive disorder (PDD) and pharmacotherapy on depression, anxiety, and somatic symptoms among patients with major depressive disorder (MDD) over a ten-year period.Methods290 outpatients with MDD were enrolled, including 117 with PDD, at baseline. Subjects were followed-up at six-month, two-year, and 10-year points. MDD and dysthymic disorder were diagnosed using the Structured Clinical Interview for DSM-IV-TR. The Hamilton Depression Rating Scale, the Hospital Anxiety and Depression Scale, and the Depression and Somatic Symptoms Scale were used. Generalized Estimating Equation models were used to investigate the impacts.ResultsMDD patients with PDD had greater severities of depression, anxiety, and somatic symptoms at the three follow-up points as compared with those without; however, these results were of statistical significance only in patients without pharmacotherapy. MDD patients with PDD had a longer duration of pharmacotherapy and a lower remission rate as compared with those without. After controlling for depression and anxiety at baseline, PDD was independently associated with more severe depression, anxiety, and somatic symptoms.LimitationAt the ten-year follow-up, approximately half of the subjects were lost to follow-up; this, in addition to the unequal follow-up intervals, might have caused bias.ConclusionsAmong the patients, PDD continued to have negative impacts on depression, anxiety, and somatic symptoms over the subsequent ten years. Differences in symptomatology between the patients with and without PDD were statistically insignificant when pharmacotherapy was utilized; however, pharmacotherapy did not fully compensate for the negative impacts of PDD.
       
  • Insomnia Predicts Increased Perceived Burdensomeness and Decreased Desire
           for Emotional Support Following an In-Laboratory Social Exclusion Paradigm
           
    • Abstract: Publication date: Available online 18 September 2018Source: Journal of Affective DisordersAuthor(s): Carol Chu, Melanie A. Hom, Austin J. Gallyer, Elizabeth A.D. Hammock, Thomas E. Joiner Background: Research suggests that insomnia is associated with elevated perceptions of loneliness and social disconnection; however, few quasi-experimental studies have tested the relationship between these constructs. This study examined whether insomnia symptom severity predicts changes in perceptions of interpersonal connectedness and desire for emotional support following in-laboratory participation in a social exclusion paradigm.Methods: Young adults (N=70) completed self-report measures assessing constructs of interest before and after engaging in a social exclusion paradigm (Cyberball). Linear regression analyses were used to evaluate whether baseline insomnia symptom severity predicted perceived burdensomeness, desire for emotional support, and thwarted belongingness after playing Cyberball; analyses controlled for baseline perceived burdensomeness, desire for emotional support, and thwarted belongingness, respectively, as well as baseline social anxiety and depression symptoms.Results: Greater insomnia symptom severity significantly predicted greater feelings of perceived burdensomeness following Cyberball participation, beyond baseline perceived burdensomeness and social anxiety and depression symptoms (β=.26, p=.001). More severe insomnia symptoms also significantly predicted lower desire for emotional support after playing Cyberball, beyond baseline desire for emotional support and social anxiety symptoms (β=-.14, p=.03) but not beyond depression symptoms (β=-.16, p=.07). Insomnia symptoms were not significantly associated with thwarted belongingness after Cyberball (β=-.05-.08, p=.27-.57).Limitations: Replication in larger samples and using other sleep disturbance indices is needed.Conclusions: Findings suggest that individuals with more severe insomnia symptoms in the past two weeks experience greater perceptions of being a burden on others and less desire for emotional support in response to social exclusion.
       
  • Affective Models of Depression and Anxiety: Extension to Within-Person
           Processes in Daily Life
    • Abstract: Publication date: Available online 17 September 2018Source: Journal of Affective DisordersAuthor(s): Kristin Naragon-Gainey BackgroundAffective models (e.g., tripartite model) delineate shared and unique components of depression and anxiety. Specifically, negative affect is broadly associated with these symptoms, whereas low positive affect is relatively specific to depression and social anxiety. However, it is unknown how affect relates to symptoms as they occur naturalistically in daily life or as a within-person dynamic process.Method135 treatment-seeking adults completed a baseline assessment of trait affect and then rated current affect and symptoms (depression, social anxiety, panic, worry) three times per day for 10 days. Multilevel modeling was used, and prospective analyses held constant current symptoms.ResultsBaseline trait negative affect and individual differences in momentary negative affect predicted all four symptoms in daily life, whereas low positive affect predicted greater depression only. Similar results were found for within-person concurrent analyses. Prospectively, momentary negative affect predicted increased depression up to 24 hours later, and increased panic or worry up to 8-16 hours later. Low momentary positive affect predicted greater depression only (8 hours later).LimitationsAll data were self-reported, and some relevant anxiety and mood symptoms were excluded. The timing of reports was random and may have missed notable symptoms. Given the novelty of the study, replication is important.ConclusionsAffective models of depression and anxiety derived from retrospective assessments demonstrated strong ecological validity. With the exception of PA and social anxiety, associations found at the between-person level generally applied to within-person processes, which may be amenable to tracking and targeting in therapy.
       
  • Attention Deficit-Hyperactivity Disorder in Adult Bipolar Disorder
           Patients
    • Abstract: Publication date: Available online 17 September 2018Source: Journal of Affective DisordersAuthor(s): Marco Pinna, Caterina Visioli, Carlo Mario Rago, Mirko Manchia, Leonardo Tondo, Ross J. Baldessarini BackgroundIt has long been recognized that bipolar disorder (BD) and attention deficit-hyperactivity disorder (ADHD) co-occur in an uncertain proportion of patients, recognized commonly in juvenile years. There is growing suspicion that such co-occurrence is associated with several clinically unfavorable characteristics. Accordingly, we compared 703 type I or II BD subjects with vs. without a lifetime diagnosis of ADHD.MethodsWe compared 173 BD patients with vs. 530 without co-occurring ADHD for selected demographic and clinical factors, using standard initial bivariate comparisons followed by multivariable logistic regression modeling.ResultsADHD was found in 25% of BD subjects, more among men and with type I BD. Those with ADHD had higher scores at the Adult ADHD Self-Report Scale (ASRS), were more likely to have had less successful school performance, unemployment, lower socioeconomic status, less marriage and more divorce, as well as more substance abuse, suicide attempts, and [hypo]mania, but were less likely to have an anxiety disorder or a family history of mood disorder. Multivariable logistic regression modeling found six factors differing between BD subjects with versus without ADHD: less education after high school, higher ASRS score for inattention, ever separated or divorced, irritable temperament, male sex, and lower scores on the Hamilton Depression Rating Scale (HDRS) at intake.CommentsCo-occurrence of ADHD with BD was identified at a moderate rate, and was associated with several unfavorable outcomes as well as a tendency toward [hypo]mania.
       
  • A quantitative meta-analysis of fMRI studies investigating emotional
           processing in excessive worriers: application of activation likelihood
           estimation analysis
    • Abstract: Publication date: Available online 17 September 2018Source: Journal of Affective DisordersAuthor(s): Fanny Weber-Goericke, Markus Muehlhan BackgroundExcessive worry is a highly impairing cognitive activity which features a range of psychological disorders. Investigations of its disturbed underlying neural mechanisms have presented largely heterogeneous results. This quantitative neuroimaging meta-analysis aims to identify consistent functional disturbances in emotional processing associated with excessive worry across previously published studies.MethodsWe used the activation likelihood estimation (ALE) method to test for significant convergence across findings of 16 neuroimaging experiments reporting functional aberrations during emotional processing between individuals experiencing high versus normal levels of worry.ResultsResults demonstrated convergent aberrations in high compared to normal worriers mainly in a left-hemispheric cluster comprising parts of the middle frontal gyrus, inferior frontal gyrus and anterior insula. Behavioral characterization indicated the identified cluster to be associated with language processing and memory, while meta-analytic connectivity mapping yielded strong functional connections between the observed convergent regions and parts of the salience network as well as the default mode network.LimitationsThe ALE method cannot consider findings based on regions of interest analyses and studies without significant group differences.ConclusionOur results indicate that in response to emotional contexts worry prone individuals exhibit disturbed functioning in brain areas which are possibly associated with deviant inner speech processes experienced by these individuals. The observed clusters may further constitute key nodes within interacting neural networks that support internally and externally oriented cognition and control the dynamic interplay among these processes.
       
  • Severity-dependent and -independent brain regions of major depressive
           disorder: a long-term longitudinal near-infrared spectroscopy study
    • Abstract: Publication date: Available online 17 September 2018Source: Journal of Affective DisordersAuthor(s): Yoshihiro Satomura, Eisuke Sakakibara, Ryu Takizawa, Shinsuke Koike, Yukika Nishimura, Hanako Sakurada, Mika Yamagishi, Chie Shimojo, Shingo Kawasaki, Naohiro Okada, Jun Matsuoka, Akihide Kinoshita, Seiichiro Jinde, Shinsuke Kondo, Kiyoto Kasai BackgroundLong-term longitudinal studies are necessary to establish neuroimaging indicators which contribute to the detection of severity changes over time in patients with major depressive disorder (MDD).MethodsOne hundred sixty-five patients with MDD underwent clinical assessments and near-infrared spectroscopy (NIRS) examination at the initial evaluation (T0). After 1.5 years, 45 patients who visited for the follow-up evaluation (T1.5) were included in the analysis. The authors conducted analyses using the 17-item Hamilton Rating Scale for Depression (HAMD) scores and mean oxy-hemoglobin concentration ([oxy−Hb]) changes during a cognitive task in NIRS at T0 (T0_HAMD, T0_[oxy−Hb]) and at T1.5 (T1.5_HAMD, T1.5_[oxy−Hb]), and their intra-individual longitudinal changes (ΔHAMD = T1.5_HAMD − T0_HAMD, Δ[oxy−Hb] = T1.5_[oxy−Hb] − T0_[oxy−Hb]).ResultsFor severity-dependent regions, the Δ[oxy−Hb] in the right inferior frontal gyrus (IFG) was negatively correlated with the ΔHAMD. For severity-independent regions, the intra-class correlation coefficients between T0_ and T1.5_[oxy−Hb] were moderate in the bilateral middle frontal gyri (MFG).LimitationsThe percentage of patients included in the follow-up examination was relatively small.ConclusionsBrain activation in the right IFG and the bilateral MFG as measured by NIRS may differentially indicate clinical severity and trait-related abnormalities in MDD.
       
  • Temperament and self-esteem in high-risk offspring of bipolar parents:
           Vulnerability and scar effects
    • Abstract: Publication date: Available online 17 September 2018Source: Journal of Affective DisordersAuthor(s): Sarah Margaret Goodday, Martin Preisig, Mehdi Gholamrezaee, Paul Grof, Anne Duffy BackgroundThe nature of the temporal relationship between psychological factors and mood episodes is unclear. The objectives of this study were to determine if temperament and self-esteem predict the onset of mood episodes, and if prior mood episodes influence the stability of these factors over time in high-risk offspring of bipolar parents.MethodsOffspring of a parent with bipolar disorder participating in the Flourish Prospective Offspring Study were clinically assessed repeatedly using semi-structured KSADS-PL/SADS-L format interviews, and completed repeated measures of self-esteem, and temperament. Shared frailty survival models and mixed effects regression models were used to determine if psychological factors predicted incident mood episodes, and whether these factors change over time after the incident mood episode, respectively.ResultsEmotionality, shyness and self-esteem were not associated with the hazard of incident major depression; however, increased activity reduced the hazard of this outcome (hazard ratio [HR]: 0.51 95% CI: 0.27, 0.98). Emotionality and shyness scores increased, while sociability, activity and self-esteem scores decreased after the incident major depressive episode (emotionality: mean change [MC]: 0.35, p=0.0289; shyness: MC: 0.40, p=0.0196; sociability: MC: -0.49, p=0.0001, activity: MC: -0.32, p=0.0001; self-esteem: MC: -0.79, p=0.001)LimitationsPsychological measures were based on self-report and some models had low numbers limiting the numbers of covariates included as potential confounders.DiscussionAmong the assessed temperamental dimensions, activity showed a protective effect for major depressive episode onset suggesting this temperamental characteristic could serve as a protective target in high risk youth. Conversely, all assessed psychological factors shifted towards increased vulnerability after the first depressive episode.
       
  • Prenatal and postnatal maternal depression and infant hospitalization and
           mortality in the first year of life: a systematic review and meta-analysis
           
    • Abstract: Publication date: Available online 17 September 2018Source: Journal of Affective DisordersAuthor(s): Nadege Jacques BackgroundPrenatal and postnatal depression have been well studied in recent decades, but few studies address their relationship with hospitalization and mortality in one-year-old children.ObjectiveReview the literature about the effects of maternal depression on hospitalization and mortality of the child from birth to one year of age and conduct a meta-analysis.MethodsA systematic search was performed in the PubMed and LILACS databases. We included original studies that evaluated the effect of prenatal and/or postnatal depressive symptoms on child hospitalization or mortality up to one year of age. Meta-analyses were conducted according to the outcome and stratified by prenatal and postnatal depression, using random effects models.ResultsSix studies were included in this review (170,371). Children of mothers with prenatal and postnatal depressive symptoms or depression had 1.44 (CI95% 1.10 – 1.89) greater risk of hospitalization, and children of mothers with postnatal depressive symptoms or depression had 1.93 (CI95% 1.02 – 3.64) greater risk of death before one year of age than those whose mothers did not have the disorder.LimitationsSmall number of studies (n
       
  • A systematic review and meta-analysis of group treatments for adults with
           symptoms associated with complex post-traumatic stress disorder
    • Abstract: Publication date: Available online 17 September 2018Source: Journal of Affective DisordersAuthor(s): Adam Mahoney, Thanos Karatzias, Paul Hutton Background: No previous meta-analyses have specifically investigated the effectiveness of psychological group therapy for symptoms associated with complex interpersonal trauma, including whether trauma memory processing (TMP) therapies are superior to psychoeducational approaches alone.Methods: A systematic review identified 36 randomised control trials (RCTs) which were included in the meta-analysis.Results: Large significant effect sizes were evident for TMP interventions when compared to usual care for three outcome domains including: PTSD (k= 6, g= -0.98, 95% CI -1.53, -0.43), Depression (k= 7, g= -1.12, 95% CI -2.01, -0.23) and Psychological Distress (k= 6, g= -0.98, 95% CI 1.66, -0.40). When TMP and psychoeducation interventions were directly compared, results indicated a small non-significant effect in favour of the former for PTSD symptoms, (k= 4, g= -0.34, 95% CI -1.05, 0.36) and small non-significant effect sizes in favour of the latter for Depression (k= 3, g= 0.29, 95% CI -0.83, 1.4) and Psychological Distress (k= 6, g= 0.19, 95% CI -0.34, 0.71).Limitations: Heterogeneity and a limited number of high quality RCTs, particularly in the Substance Misuse and Dissociation domains, resulted in uncertainty regarding meta-analytical estimates and subsequent conclusions.Conclusions: Results suggest that TMP interventions are useful for traumatic stress whereas non-TMP interventions can be useful for symptoms of general distress (e.g. anxiety and depression). Thus, both TMP and psychoeducation can be useful for the treatment of complex interpersonal trauma symptoms and further research should unravel appropriate sequencing and dose of these interventions.
       
  • Adhering to a vegetarian diet may create a greater risk of depressive
           symptoms in the elderly male Chinese population
    • Abstract: Publication date: Available online 17 September 2018Source: Journal of Affective DisordersAuthor(s): Xiu-de LI, Hong-juan CAO, Shao-yu XIE, Kai-chun LI, Fang-biao TAO, Lin-sheng YANG, Jun-qing ZHANG, Yuan-song BAO BackgroundA vegetarian diet may be a risk factor for depression, but this relationship was unclear in the elderly Chinese population.MethodsSelf-report data were gathered from 1,051 elderly persons using the Cohort of Elderly Health and Environment Controllable Factors, which was created in West Anhui, China. The depressive symptoms were set as binary, ordinal, and continuous outcomes, respectively, whereas the dietary structures were computed as an ordinal variable and a dummy variable. Multiple logistic regression, ordinal regression, and linear regression were used to assess the relationship by adjusting the potential confounding variables with p-values of < 0.1 in univariate analysis.ResultsThe elderly participants who had a vegetable-based diet had the highest GDS scores of 8.78 ± 6.894 (p = 0.001) and the highest rate of depression (32.9%, p = 0.003). After adjustment for the potential confounders, elderly men who had a vegetable-based diet had a higher rate of depression (OR[95%CI]: 1.62[1.07–2.46], 4.71[1.38–16.03]), more severe symptoms of depression (OR[95%CI]: 8.85[2.94–34.12]), and higher GDS scores (β[95%CI]: 1.46[0.70–2.22], 2.97[1.28-4.67]) than male participants who had a meat-based diet, but this was not the case in women.LimitationsAll data were self-reported. The study lacked quantitatively evaluated dietary intake. The duration of the current dietary structures and comorbidities were not reported. The cross-sectional study made the causal role uncertain.ConclusionsVegetarian diets may pose a greater risk of depressive symptoms among the elderly Chinese population, especially elderly men. Given the cross-sectional nature of this study, the causal role was uncertain. Further prospective studies, in particular among elderly women, are needed.
       
  • Neuroticism and extraversion mediate the relationship between having a
           sibling with developmental disabilities and anxiety and depression
           symptoms
    • Abstract: Publication date: Available online 17 September 2018Source: Journal of Affective DisordersAuthor(s): Lindsay E Murray, Linda O'Neill Background: Children growing up with a sibling with disabilities report higher levels of depression and anxiety symptoms as adults. Here, we examined whether personality characteristics also play a part in mediating this relationship.Method: We tested for differences in personality traits between 132 individuals who have a sibling with developmental disabilities and 132 closely matched comparisons.Results: Differences in Big Five factors of personality were demonstrated across the disability groups and between the disability groups and the comparisons, especially in Extraversion, Neuroticism and Openness. Individuals growing up alongside a sibling with developmental disabilities have a higher tendency to experience anxiety and depression symptoms, and this research is the first demonstration that personality traits mediate this relationship. Specifically, Neuroticism is a strong mediator of anxiety while both Neuroticism and Extraversion contribute mediating effects toward the development of depression.Limitations: Our study made use of self-report methodology which, although having recognized limitations, is more reliable than parental reports. Given the cross-sectional nature of our design, we were not able to examine pre-existing developmental factors that may have influenced the participant's propensity to particular personality traits and affective disorders. However, we obtained a large sample and closely matched participants to examine differences between those with a sibling with disabilities and those without.Conclusions: As such, differences in personality traits have important implications for the understanding and treatment of siblings presenting with anxiety and depression symptoms. We recommend that intervention should target those high in Neuroticism among individuals who have a sibling with disabilities, and that more social support is put in place for siblings to mitigate their tendency towards introversion and buffer them against psychological maladjustment.
       
  • Shame as a mediator between posttraumatic stress disorder symptoms and
           suicidal ideation among veterans
    • Abstract: Publication date: Available online 17 September 2018Source: Journal of Affective DisordersAuthor(s): Katherine C. Cunningham, Stefanie T. LoSavio, Paul A. Dennis, Chloe Farmer, Carolina P. Clancy, Michael A. Hertzberg, Nathan A. Kimbrel, Patrick S. Calhoun, Jean C. Beckham BackgroundSuicidal ideation is a problem that disproportionately affects veterans. Moreover, veterans with posttraumatic stress disorder (PTSD) appear to be at particularly high risk for suicide.ObjectiveThe purpose of the present research was to examine whether shame mediates the association between PTSD and suicidal ideation.MethodsSecondary analyses were conducted in a sample of 201 veterans with PTSD seeking care through an outpatient Veterans Affairs specialty PTSD clinic.ResultsPath analysis revealed that shame fully accounted for the effects of PTSD on suicidal ideation, suggesting that shame may represent a key link between PTSD and suicidal ideation among veterans.LimitationsAlthough the reverse mediation effect was also examined, the present sample was cross-sectional and predominantly male.ConclusionsThe present findings suggest that shame may be an effective point of treatment intervention to reduce suicidal ideation among veterans with PTSD; however, additional prospective research is still needed to delineate the precise nature of these associations over time.
       
  • Posttraumatic Stress Disorder Following the 2008 Wenchuan Earthquake: A
           10-year Systematic Review Among Highly Exposed Populations in China
    • Abstract: Publication date: Available online 17 September 2018Source: Journal of Affective DisordersAuthor(s): Yiming Liang, Jin Cheng, Josef I. Ruzek, Zhengkui Liu BackgroundThe 2008 Wenchuan earthquake was unprecedented in Chinese history both in terms of the magnitude of the quake itself and the scale of human suffering. Following the disaster, researchers reported on a wide range of mental health outcomes, especially posttraumatic stress disorder (PTSD). In this review, we assess the cumulative body of research evidence about PTSD across the first 10 years following the earthquake.MethodsWe searched the literature in the PubMed, Web of Science, and China National Knowledge Infrastructure (CNKI) databases (from May 2008 to February 2018) using Wenchuan earthquake and PTSD as keywords.ResultsWe selected 58 relevant studies. Published findings from the selected period suggested a substantial burden of PTSD on highly exposed survivors. Studies have found that symptoms of PTSD have been associated with a range of risk factors, including sociodemographic factors, trauma exposure characteristics, post-disaster cognitive and emotional states, and social support. Studies have explored the factor structure of PTSD in the affected Chinese population, and researchers have developed a Chinese self-report measure of PTSD symptoms. Several treatments for PTSD have been evaluated, including some indigenous intervention methods.LimitationsOnly a relatively small number of the studies used longitudinal assessments, and the consistency and effectiveness of measurement tools for PTSD require further exploration. More rigorous investigations of the effectiveness of interventions for the prevention and treatment of PTSD are needed.ConclusionThe 10-year body of literature is important for the future deployment of disaster relief and an increased understanding of PTSD in China.
       
  • Frequency of Social Contact In-Person vs. on Facebook: An Examination of
           Associations with Psychiatric Symptoms in Military Veterans
    • Abstract: Publication date: Available online 17 September 2018Source: Journal of Affective DisordersAuthor(s): Alan R. Teo, Benjamin Chan, Somnath Saha, Christina Nicolaidis IntroductionSocial isolation is closely associated with negative mental health outcomes. Social media platforms may expand opportunities for social contact, but whether online interactions are as effective as face-to-face, or in-person, interactions at protecting against the negative effects of social isolation is unclear.MethodsParticipants consisted of U.S. military veterans who served since September 2001 and used Facebook (n=587). Our independent variables were frequency of social contact occurring in-person and on Facebook. Dependent variables were probable psychiatric disorders and suicidality, measured using several validated screening tools. The independent effect of each form of social contact was assessed using multivariate logistic regression, which included adjustment for several potential confounders.ResultsWe found that veterans who frequently interacted on Facebook engaged in more in-person social contact than infrequent Facebook users (p < 0.001). More frequent in-person social interaction was associated with significantly decreased risk of symptoms of major depression and PTSD, compared with contact every few weeks or less. In contrast, increased frequency of social interaction on Facebook had no associations with mental health outcomes.LimitationsAll associations are cross-sectional (direction of association is unclear) and based on self-report measures.ConclusionsAlthough veterans who frequently use Facebook are also typically social in their offline life, it is their offline (in-person) social interaction, rather than their social contact on Facebook, that is associated with reduced psychiatric symptoms.
       
  • Sugar consumption and attention-deficit/hyperactivity disorder (ADHD): a
           birth cohort study
    • Abstract: Publication date: Available online 17 September 2018Source: Journal of Affective DisordersAuthor(s): Bianca Del-Ponte, Luciana Anselmi, Maria Cecília F. Assunção, Luciana Tovo-Rodrigues, Tiago N Munhoz, Alicia Matijasevich, Luis Augusto Rohde, Iná S. Santos BackgroundAttention-deficit/hyperactivity disorder (ADHD) is characterized by persistent symptoms of lack of attention, impulsivity and hyperactivity. The association between nutritional exposures and ADHD has been investigated and some studies have identified adverse effects from higher intake of sugar. The objective of the present study was to evaluate the association between change in sugar consumption between 6 and 11 years of age and incidence of attention-deficit/hyperactivity disorder (ADHD).MethodsPelotas 2004 Birth Cohort Study in Brazil. A food frequency questionnaire (FFQ) was used to estimate sugar consumption and the Development and Well-Being Assessment (DAWBA) was applied to mothers to assess the presence of ADHD.ResultsOnly children without ADHD at 6 years and with complete information from FFQ and DAWBA at 6 and 11 years were included in the analyses (n = 2924). Odds ratios with 95% confidence intervals were calculated. Incidence of ADHD between 6 and 11 years was 4.6% (3.6-5.6%) among boys and 1.8% (1.2-2.5%) among girls. Adjusted analyses showed no association between always-high sucrose consumption between 6 and 11 years and incidence of ADHD, compared with individuals who always presented low consumption, both among boys (OR = 0.66; 0.21–2.04) and girls (OR = 2.71; 0.24–30.35).LimitationsReflect those that are inherent to use of FFQs, such as memory bias and lack of precision in quantifying the diet.ConclusionsThe results suggest that there is no association between sucrose consumption between 6 and 11 years of age and incidence of ADHD.
       
  • Maternal Pre- and Postnatal Anxiety Symptoms and Infant Attention
           Disengagement from Emotional Faces
    • Abstract: Publication date: Available online 17 September 2018Source: Journal of Affective DisordersAuthor(s): Eeva-Leena Kataja, Linnea Karlsson, Christine E. Parsons, Juho Pelto, Henri Pesonen, Tuomo Häikiö, Jukka Hyönä, Saara Nolvi, Riikka Korja, Hasse KarlssonABSTRACTBackground: Biases in socio-emotional attention may be early markers of risk for self-regulation difficulties and mental illness. We examined the associations between maternal pre- and postnatal anxiety symptoms and infant attention patterns to faces, with particular focus on attentional biases to threat, across male and female infants.Methods: A general population, Caucasian sample of eight-month old infants (N=362) were tested using eye-tracking and an attention disengagement (overlap) paradigm, with happy, fearful, neutral, and phase-scrambled faces and distractors. Maternal self-reported anxiety symptoms were assessed with the Symptom Checklist-90/anxiety subscale at five time points between gestational week 14 and 6 months postpartum.Results: Probability of disengagement was lowest for fearful faces in the whole sample. Maternal pre- but not postnatal anxiety symptoms associated with higher threat bias in infants, and the relation between maternal anxiety symptoms in early pregnancy remained significant after controlling for maternal postnatal symptoms. Maternal postnatal anxiety symptoms, in turn, associated with higher overall probability of disengagement from faces to distractors, but the effects varied by child sex.Limitations: The small number of mothers suffering from very severe symptoms. No control for the comorbidity of depressive symptoms.Conclusions: Maternal prenatal anxiety symptoms may enhance infant's attention bias for threat. Maternal postnatal anxiety symptoms, in turn, may associate with infant's overall disengagement probability differently for boys and girls. Boys may show enhanced vigilance for distractors, (except when viewing fearful faces), and girls enhanced vigilance for all socio-emotional. Long-term implications of these findings remain to be explored.
       
  • Pretreatment brain connectivity during positive emotion upregulation
           predicts decreased anhedonia following Behavioral Activation Therapy for
           Depression
    • Abstract: Publication date: Available online 17 September 2018Source: Journal of Affective DisordersAuthor(s): Erin C. Walsh, Tory A. Eisenlohr-Moul, Jared Minkel, Joshua Bizzell, Chris Petty, Andrew Crowther, Hannah Carl, Moria J. Smoski, Gabriel S. Dichter BackgroundNeurobiological predictors of antidepressant response may help guide treatment selection and improve response rates to available treatments for Major Depressive Disorder (MDD). Behavioral Activation Therapy for Depression (BATD) is an evidence-based intervention designed to ameliorate core symptoms of MDD by promoting sustained engagement with value-guided, positively-reinforcing activities. The present study examined pre-treatment task-based functional brain connectivity as a predictor of antidepressant response to BATD.MethodsThirty-three outpatients with MDD and 20 nondepressed controls completed a positive emotion regulation task during fMRI after which participants with MDD received up to 15 sessions of BATD. We used generalized psychophysiological interaction analyses to examine group differences in pre-treatment functional brain connectivity during intentional upregulation of positive emotion to positive images. Hierarchical linear models were used to examine whether group differences in functional connectivity predicted changes in depression and anhedonia over the course of BATD.ResultsCompared to controls, participants with MDD exhibited decreased connectivity between the left middle frontal gyrus and right temporoparietal regions during upregulation of positive emotion. Within the MDD group, decreased connectivity of these regions predicted greater declines in anhedonia symptoms over treatment.LimitationsFuture studies should include comparison treatments and longitudinal follow-up to clarify the unique effects of BATD on neural function and antidepressant response.ConclusionsResults are consistent with previous work showing BATD may be particularly effective for individuals with greater disturbances in brain reward network function, but extend these findings to highlight the importance of frontotemporoparietal connectivity in targeting symptoms of low motivation and engagement.
       
  • GWAS and systems biology analysis of depressive symptoms among smokers
           from the COPDGene cohort
    • Abstract: Publication date: 15 January 2019Source: Journal of Affective Disorders, Volume 243Author(s): Jonathan T. Heinzman, Karin F. Hoth, Michael H. Cho, Phuwanat Sakornsakolpat, Elizabeth A. Regan, Barry J. Make, Gregory L. Kinney, Frederick S. Wamboldt, Kristen E. Holm, Nicholas Bormann, Julian Robles, Victor Kim, Anand S. Iyer, Edwin K. Silverman, James D. Crapo, Shizhong Han, James B. Potash, Gen Shinozaki, COPDGene Investigators BackgroundLarge sample GWAS is needed to identify genetic factors associated with depression. This study used genome-wide genotypic and phenotypic data from the COPDGene study to identify genetic risk factors for depression.MethodsData were from 9716 COPDGene subjects with ≥10 pack-year history. Depression was defined as antidepressant use and/or a HADS depression subscale score ≥8. Non-Hispanic White (6576) and African-American (3140) subsets were analyzed. A GWAS pipeline identified SNPs associated with depression in each group. Network analysis software analyzed gene interactions through common biological pathways, genetic interactions, and tissue-specific gene expression.ResultsThe mean age was 59.4 years (SD 9.0) with 46.5% female subjects. Depression was in 24.7% of the NHW group (1622) and 12.5% of the AA group (391). No SNPs had genome-wide significance. One of the top SNPs, rs12036147 (p = 1.28 × 10−6), is near CHRM3. Another SNP was near MDGA2 (rs17118176, p = 3.52 × 10−6). Top genes formed networks for synaptic transmission with a statistically significant level of more co-expression in brain than other tissues, particularly in the basal ganglia (p = 1.00 × 10−4).LimitationsLimitations included a depression definition based on antidepressant use and a limited HADS score subgroup, which could increase false negatives in depressed patients not on antidepressants. Antidepressants used for smoking cessation in non-depressed patients could lead to false positives.ConclusionsSystems biology analysis identified statistically significant pathways whereby multiple genes influence depression. The gene set pathway analysis and COPDGene data can help investigate depression in future studies.
       
  • Predictive value of early MRI findings on neurocognitive and psychiatric
           outcomes in patients with severe traumatic brain injury
    • Abstract: Publication date: 15 January 2019Source: Journal of Affective Disorders, Volume 243Author(s): Nasser M. Aldossary, Mamdouh Ali Kotb, Ahmed M. Kamal BackgroundTraumatic brain injury (TBI) is the major public health problem worldwide, particularly in the Middle East. Diffuse axonal injury (DAI) is commonly found in TBI. Although DAI can lead to physical and psychosocial disabilities, its prognostic value is still a matter of debate. Magnetic Resonance (MR) is more sensitive for detecting DAI lesions.ObjectiveTo identify the radiological and clinical factors associated with the functional capacity one year after the traumatic brain injury.MethodsThe study included 251 patients with severe head trauma for whom Brain MRI was done within one month after injury. Demographic, clinical, and radiological data were collected during hospitalization. Neurocognitive and psychiatric evaluation were done one year thereafter.ResultsDAI was more frequent in our patients. Psychiatric disorders, cognitive impairment, and poor functional outcome were more common in patients with DAI especially those with cerebral hemisphere and brain stem lesion, and mixed lesions. Duration of post traumatic amnesia (DPTA), lost consciousness and hospital stay (DHS) as well as the volume of diffuse axonal injury (DAI) were associated with poor neurocognitive outcome. DPTA, and DAIV may be considered independent factors that could predict the neurocognitive outcome.ConclusionMRI following traumatic brain injury yields important prognostic information, with several lesion patterns significantly associated with poor long-term neurocognitive and psychiatric outcomes.
       
  • Biased neurocognitive self-perception in depression - What is the reason
           for the discrepancy' Reply to Dehn & Beblo (2018)
    • Abstract: Publication date: Available online 13 September 2018Source: Journal of Affective DisordersAuthor(s): Christine Schwert
       
  • Suicide and other sudden death bereavement of immediate family members: An
           analysis of grief reactions six-months after death
    • Abstract: Publication date: Available online 12 September 2018Source: Journal of Affective DisordersAuthor(s): Kairi Kõlves, Qing Zhao, Victoria Ross, Jacinta Hawgood, Susan H Spence, Diego de Leo Introduction: While suicide bereavement has been assumed to be different from bereavement following death by other modes, a number of studies have reported that there are several similarities, particularly for violent deaths. The aims of the current study are to test, using confirmatory factor analysis, the factor structure of Grief Experience Questionnaire (GEQ) that has been proposed in other studies; and to compare short term grief reactions, mental health, and suicidality six-months after bereavement in close family members bereaved by suicide versus sudden death.Methods: Participants were 142 adults who were bereaved following a suicide and 63 who were bereaved following the sudden death of a family member. Data were collected six-months after the death.Results: Analyses did not show good fits for the factor structures proposed for the GEQ in earlier studies. However, a relatively good fit was found for an 8-factor version of the originally proposed GEQ. Bereavement type (suicide vs sudden death) significantly predicted rejection, somatic reactions, stigmatisation, responsibility and shame on the GEQ, after adjusting for kinship type, gender, age, pre-bereavement diagnosis of mental illness and self-harm behaviours of both the deceased and the bereaved, and current mental health and suicidal ideation of the bereaved.Limitations: Different recruitment methods were used and response rates were relatively low.Conclusions: The new knowledge of bereaved experiences specific to suicide loss at six-months post death, should be channelled into determining the most practical and satisfactory ways to alleviate the impacts of these potentially changeable states of experience.
       
  • Measurement equivalence of the Social Interaction Anxiety Scale (SIAS) and
           Social Phobia Scale (SPS) across individuals with social anxiety disorder
           from Japanese and Australian sociocultural contexts
    • Abstract: Publication date: Available online 12 September 2018Source: Journal of Affective DisordersAuthor(s): Quincy J.J. Wong, Junwen Chen, Bree Gregory, Andrew J. Baillie, Toshihiko Nagata, Toshiaki A. Furukawa, Hisanobu Kaiya, Lorna Peters, Ronald M. Rapee BackgroundCultural factors influence both the expression of social anxiety and the interpretation and functioning of social anxiety measures. This study aimed to test the measurement equivalence of two commonly used social anxiety measures across two sociocultural contexts using individuals with social anxiety disorder (SAD) from Australia and Japan.MethodsScores on the straightforwardly-worded Social Interaction Anxiety Scale (S-SIAS) and the Social Phobia Scale (SPS) from two archival datasets of individual with SAD, one from Australia (n = 201) and one from Japan (n = 295), were analysed for measurement equivalence using a multigroup confirmatory factor analysis (CFA) framework.ResultsThe best-fitting factor models for the S-SIAS and SPS were not found to be measurement equivalent across the Australian and Japanese samples. Instead, only a subset of items was invariant. When this subset of invariant items was used to compare social anxiety symptoms across the Australian and Japanese samples, Japanese participants reported lower levels of fear of attracting attention, and similar levels of fear of overt evaluation, and social interaction anxiety, relative to Australian participants.LimitationsWe only analysed the measurement equivalence of two social anxiety measures using a specific operationalisation of culture. Future studies will need to examine the measurement equivalence of other measures of social anxiety across other operationalisations of culture.ConclusionsWhen comparing social anxiety symptoms across Australian and Japanese cultures, only scores from measurement equivalent items of social anxiety measures should be used. Our study highlights the importance of culturally-informed assessment in SAD.
       
  • Identifying and differentiating melancholic depression in a non-clinical
           sample
    • Abstract: Publication date: Available online 12 September 2018Source: Journal of Affective DisordersAuthor(s): Gordon Parker, Gabriela Tavella, Dusan Hadzi-Pavlovic BackgroundDifferentiating melancholic and non-melancholic depressive disorders and evaluating whether they differ categorically or dimensionally has had a lengthy history, but has not previously been evaluated in a non-clinical adolescent sample.MethodsWe studied a sample of 1,579 senior high school students and evaluated the capacity of the Sydney Melancholia Prototype Index (SMPI) to differentiate melancholic from non-melancholic depression, both using a ‘top down’ strategy of imposing a pre-established cut-off score and a ‘bottom up’ strategy of employing latent class analyses.ResultsThe two strategies respectively generated prevalence figures of 3.4% and 8.1% of the students having experienced a melancholic depressive episode and with the difference reflecting the LCA assigning some students who did not reach the pre-established cut-off score for the SMPI in the putative melancholic class. The principal latent class analysis failed to generate pristine melancholic and non-melancholic depressive classes, in that it also generated an ‘intermediate’ as well as a non-clinical depressive class. Both SMPI strategies identified similar symptoms - such as anhedonia and anergia - and several illness correlates that best differentiated those assigned a melancholia status, and both strategies confirmed melancholia assignment being associated with factors indicative of more severe depressive disorders and of likely melancholic depression.LimitationsData were assessed by self-report only, only lifetime depression was assessed, and no other depressive diagnostic validating measure was administered.ConclusionsThe SMPI appears capable of identifying and differentiating melancholic from non-melancholic depression in a non-clinical adolescent sample.
       
  • Prevalence and risk factors of excessive daytime sleepiness in major
           depression: A study with 703 individuals referred for polysomnography
    • Abstract: Publication date: Available online 11 September 2018Source: Journal of Affective DisordersAuthor(s): Matthieu Hein, Jean-Pol Lanquart, Gwenolé Loas, Philippe Hubain, Paul Linkowski Background: To date, few studies have investigated the prevalence and risk factors of excessive daytime sleepiness (EDS) in major depression. Thus, the aim of the present study was to examine the prevalence and risk factors of EDS in a large sample of individuals with major depression.Methods: Data from 703 individuals with major depression were retrospectively collected from the sleep laboratory research database of Erasme Hospital for analysis. A score of>10 on the Epworth Sleepiness Scale was used as the cut-off for EDS. Logistic regression analyses were conducted to examine the clinical and demographic risk factors of EDS in major depression.Results: The prevalence of EDS in our sample was 50.8%. Multivariate logistic regression analysis revealed that the following were significant risk factors of EDS in major depression: non-use of short to intermediate half-life benzodiazepine receptor agonists, BMI ≥25 kg/m², age 7 mg/L, Beck Depression Inventory score ≥16, atypical depression, apnea-hypopnea index ≥15/h, and use of selective serotonin reuptake inhibitors or serotonin–norepinephrine reuptake inhibitors.Limitations: To evaluate EDS, we used the Epworth Sleepiness Scale, which only allows for a subjective measure of daytime sleepiness.Conclusion: EDS is a common symptom in individuals with major depression. In this subpopulation, interventions are possible for most risk factors of EDS, which justifies improved management of this symptom to avoid its negative consequences.
       
  • The effects of childhood maltreatment and anxiety proneness on
           neuropsychological test performance in non-clinical older adolescents
    • Abstract: Publication date: Available online 11 September 2018Source: Journal of Affective DisordersAuthor(s): Lindi Martin, Martin Kidd, Soraya Seedat BackgroundThe effect of childhood maltreatment (CM) on neuropsychological performance is well established, but the effect of anxiety proneness (AP) on such performance has been underexplored. We assessed the predictive ability of CM and AP, and their interaction, in non-clinical adolescents, for a range of previously documented neuropsychological deficits.MethodsMultiple linear regression models were used to assess the unique and combined influences of CM and AP on neuropsychological performance in 104 non-clinical adolescents, who underwent both neuropsychiatric and neuropsychological assessment.ResultsThe interaction of CM and AP was associated with poorer performance in executive functioning skills, processing speed, and estimated IQ. CM and AP were uniquely associated with verbal working memory performance, while verbal and visual memory performance and learning, and visuo-spatial ability, were not associated with either CM, AP or the interaction of CM and AP.LimitationsThe use of self-report measures to determine participants’ levels of CM, AP, and depression. The CTQ-SF, a retrospective self-report measure, may have introduced recall bias. The neuropsychological evaluation was not conducted in the Xhosa language, the first language of most African participants. Most instruments utilized have not been validated in a South African adolescent sample. The impact of important moderator variables (e.g. age of onset of maltreatment) was not assessed.ConclusionsIncreased levels of CM and AP may be risk markers for poor performance in several key neuropsychological domains. Our findings underscore the importance of assessing the impact of both CM and anxiety-related temperamental traits on neuropsychological performance.
       
  • Perinatal depression among a global sample of Spanish-speaking of women: A
           sequential-process latent growth-curve analysis
    • Abstract: Publication date: Available online 11 September 2018Source: Journal of Affective DisordersAuthor(s): Elizabeth A. Carter, Melissa J. Bond, Robert E. Wickham, Alinne Z. Barrera BackgroundDespite high rates of perinatal depression among women from diverse backgrounds, the understanding of the trajectory of depressive symptoms is limited. The aim of this study was to investigate the trajectories of depressive symptoms from pregnancy to postpartum among an international sample of pregnant women.MethodsHispanic/Latino (79.2%), Spanish-speaking (81%) pregnant women (N=1796; Mean age=28.32, SD=5.51) representing 78 unique countries/territories participated in this study. A sequential-process latent growth-curve model was estimated to examine general trajectories of depression as well as risk and protective factors that may impact depression levels throughout both the prenatal and postpartum periods.ResultsOverall, depression levels decreased significantly across the entire perinatal period, but this decrease slowed over time within both the prenatal and postpartum periods. Spanish-speaking women, those who were partnered, and those with no history of depression reported lower levels of depression during early pregnancy, but this buffer effect reduced over time. Depression levels at delivery best predicted postpartum depression trajectories (i.e., women with higher levels of depression at delivery were at greater risk for depression postpartum).LimitationsGiven the emphasis on language and not country or culture of origin this study was limited in its ability to examine the impact of specific cultural norms and expectations on perinatal depression.ConclusionsGiven these findings, it is imperative that providers pay attention to, and assess for, depressive symptoms and identified buffers for depression, especially when working with women from diverse communities.
       
  • Simvastatin therapy in adolescent mice attenuates HFD-induced
           depression-like behavior by reducing hippocampal neuroinflammation
    • Abstract: Publication date: Available online 11 September 2018Source: Journal of Affective DisordersAuthor(s): Huali Wu, Wenting Lv, Qi Pan, Praveen Kumar Kalavagunta, Qiongzhen Liu, Guohong Qin, Minxuan Cai, Liangliang Zhou, Tao Wang, Zhenjiang Xia, Jing Shang BackgroundA high-fat diet (HFD)-induced obesity/hyperlipidemia is accompanied by hormonal and neurochemical changes that can be associated with depression. Emerging studies indicate that simvastatin (SMV, decreasing cholesterol levels) has therapeutic effects on neurological and neuropsychiatric diseases through hippocampal-dependent function. However, the studies on the HFD exposure in adolescent animals, which investigate the neuroprotective effects of SMV on the hippocampal morphology, serotonin (5-HT) system and inflammation, are limited. Hence, the aim of this study was to determine whether SMV attenuates HFD-induced major depressive disorders in adolescent animals and, more specifically, acts as an anti-neuroinflammatory response.MethodsTwenty-four male C57BL/6 mice were fed a control (n=8), HFD (n=8) and HFD+SMV (n=8) for 14 weeks. In HFD+SMV group, SMV (10 mg/kg) was administrated from the 10th week of HFD feeding. The open field test (OFT) and the tail suspension test (TST) were used to examine the effect of SMV on behavioral performance. HE and Nissl staining were conducted to detect hippocampal morphology and neural survival. Expression of the inflammatory cytokine genes was assayed by quantitative polymerase chain reaction (Q-PCR).ResultsFirstly, alterations in lipid parameters were minimized after SMV treatment. HFD-induced depression-like behavior, which was evidenced by an increase in immobility time in TST along with considerable decrease in locomotion activity, was significantly attenuated by SMV therapy for 4 weeks. Additionally, SMV could reduce HFD-induced structural abnormality, neuronal injury, serotonergic system disturbance and pro-inflammatory cytokine over-expression in the hippocampus. Neuroimmunological changes in central hippocampus displayed a similar characteristic (only IL-1β, IL-6, TNF-α) with that in periphery spleen, whereas they appeared in an entirely opposite trend with that in cerebral cortex.ConclusionOur results suggest that SMV may be a promising treatment for HFD-induced depression-like behavior during adolescent period through brain region-specific neuroninflammatory mechanisms.
       
  • Sequential risk of depression in children born prematurely: A nationwide
           population- based analysis
    • Abstract: Publication date: Available online 11 September 2018Source: Journal of Affective DisordersAuthor(s): Ting-Fang Chiu, Tung-Min Yu, Ya-Wen Chuang, Kuo-Ting Sun, Chi-Yuan Li, Yuan-Chih Su, Chia-Hung Kao BackgroundWhether children born prematurely are at a high risk of depression is still unknown. The present study examined the risk of depression in children who were born prematurely, by analyzing a national cohort in Taiwan.MethodsAll premature births between January 1, 2000, and December 31, 2010, by using the Taiwan National Health Insurance Research Database. A total of 21,478 preterm children and 85,903 full-term children were enrolled in this study. Sex, level of urbanization of residential area, and parental occupation were considered. We included participants who received a diagnosis of depression in more than two clinical visits or were hospitalized due to depression.ResultsPreterm children had a 2.75-fold higher risk of depression than full-term children (95% confidence interval [CI] = 1.58–4.79, p < 0.001). Sex was not likely to be associated with depression in this study (p = 0.95). The lowest level of urbanization significantly contributed to the risk of depression in preterm children (adjusted hazard ratio = 6.8, 95% CI = 1.63–28.46, p < 0.01). Regarding parental occupation, preterm children whose parents had blue-collar and other occupations had a 3.4- and 6.06-fold higher risk of depression, respectively, compared with other children (blue-collar occupations: 95% CI = 1.04–11.15, p < 0.05; other occupations: 95% CI = 1.71–21.49, p < 0.01).ConclusionsPreterm children had a 2.7-fold higher risk of depression than children born full-term. Early identification, timely psychiatric care, intervention strategies, and support for their families may reduce the complications of mental illness in preterm children.
       
  • Clinical features of differential diagnosis between unipolar and bipolar
           depression in a drug-free sample of young adults
    • Abstract: Publication date: Available online 11 September 2018Source: Journal of Affective DisordersAuthor(s): André Machado Patella, Taiane Cardoso IntroductionSubjects with bipolar disorder suffering of a depressive episode are frequently misdiagnosed as unipolar depression, being important studies assessing the differential diagnosis between bipolar and unipolar depression.ObjectiveTo assess the sociodemographic and clinical features of drug-free young adults in a depressive episode of bipolar or unipolar disorder in order to identify factors that may differentiate these psychiatric conditions.MethodsThis is a cross-sectional study with 241 young adults aged between 18 and 29 years who were evaluated using the Structured Clinical Interview for DSM-IV (SCID). The sample comprised patients with BD (n=89) and major depressive disorder (n=152), experiencing a depressive episode and not using psychoactive drugs or illicit psychoactive substances.ResultsThe characteristics associated with bipolar depression were being male (p < 0.001), with a family history of BD (p = 0.013), a higher frequency of childhood traumatic experiences (p = 0.001), younger age of onset of mood disorder (p = 0.004), many previous depressive episodes (p = 0.027), greater severity of depressive symptoms (p < 0.001) and day/night reversal (p = 0.013). Those with unipolar depression showed a higher frequency of biological rhythm disturbances (p < 0.001), and diurnal preference (p = 0.028).LimitationsThe sample has not included subjects with severe suicide risk, a possible important marker in differentiate unipolar from bipolar depression.ConclusionSome clinical aspects may contribute to an early differential diagnosis of both bipolar and unipolar depression even in the initial stages of the disease.
       
  • White matter – emotion processing activity relationships in youth
           offspring of bipolar parents
    • Abstract: Publication date: Available online 11 September 2018Source: Journal of Affective DisordersAuthor(s): Heather E. Acuff, Amelia Versace, Michele A. Bertocci, Lindsay C. Hanford, Cecile D. Ladouceur, Anna Manelis, Kelly Monk, Lisa Bonar, Alicia McCaffrey, Benjamin I. Goldstein, Tina R. Goldstein, Dara Sakolsky, David Axelson, LAMS Consortium, Boris Birmaher, Mary L. Phillips Background: Early detection of Bipolar Disorder (BD) is critical for targeting interventions to delay or prevent illness onset. Yet, the absence of objective BD biomarkers makes accurately identifying at-risk youth difficult. In this study, we examined how relationships between white matter tract (WMT) structure and activity in emotion processing neural circuitry differentiate youth at risk for BD from youth at risk for other psychiatric disorders.Methods: Offspring (ages 8-17) of parents with BD (OBP, n=32), offspring of comparison parents with non-BD psychopathology (OCP, n=30), and offspring of healthy parents (OHP, n=24) underwent diffusion tensor and functional magnetic resonance imaging while performing an emotional face processing task. Penalized and multiple regression analyses included GROUP(OBP,OCP)xWMT interactions as main independent variables, and emotion processing activity as dependent variables, to determine significant group differences in WMT-activity relationships.Results: 8 GROUPxWMT interaction variables contributed to 16.5% of the variance in amygdala and prefrontal cortical activity to happy faces. Of these, significant group differences in slopes (inverse for OBP, positive for OCP) existed for the relationship between forceps minor radial diffusivity and rostral anterior cingulate activity (p=0.014). Slopes remained significantly different in unmedicated youth without psychiatric disorders (p=0.017) and were moderated by affective lability symptoms (F(1,29)=5.566, p=.036).Limitations: Relatively small sample sizes were included.Conclusions: Forceps minor radial diffusivity-rostral anterior cingulate activity relationships may reflect underlying neuropathological processes that contribute to affectively labile youth at risk for BD and may help differentiate them from youth at risk for other psychiatric disorders.
       
  • White Matter Abnormalities Predict Residual Negative Self-Referential
           Thinking Following Treatment of Late-Life Depression with Escitalopram: A
           Preliminary Study
    • Abstract: Publication date: Available online 11 September 2018Source: Journal of Affective DisordersAuthor(s): Lindsay W. Victoria, George S. Alexopoulos, Irena Ilieva, Aliza T. Stein, Matthew J. Hoptman, Naib Chowdhury, Matteo Respino, Sarah Shizuko Morimoto, Dora Kanellopoulos, Jimmy N. Avari, Faith M. Gunning BackgroundNegative self-referential thinking is a common symptom of depression associated with poor treatment response. In late-life depression, white matter abnormalities may contribute to negative self-referential thoughts following antidepressant treatment. We investigated the association of fractional anisotropy (FA) in select regions of the negative valence system (NVS) with residual negative self-referential thoughts following treatment with escitalopram for late-life depression.MethodsThe participants were older adults with major depression and psychiatrically normal controls. Depressed participants received 12 weeks of treatment with escitalopram. To assess self-referential thinking, participants completed a Trait Adjective Task at baseline and at week 12. Baseline MRI scans included a diffusion imaging sequence for FA analyses.ResultsParticipants with late-life depression differed from controls on all performance measures of the Trait Adjective Task at baseline and at 12 weeks. Depressed participants endorsed fewer negative personality traits and more positive personality traits at week 12 compared to baseline. Lower FA in the dorsal anterior cingulate and in the uncinate fasciculus in depressed participants was correlated with residual negative self-referential thinking (e.g., more endorsed negative adjectives, fewer rejected negative adjectives) at treatment end.LimitationsThe sample size is modest so the findings are preliminary. FA analyses were restricted to predetermined regions.ConclusionsNegative self-referential thinking improved in depressed older adults following 12 weeks of treatment with escitalopram. Baseline FA in select white matter regions of the NVS was associated with residual negative self-referential thinking. These findings may help identify treatment targets for residual negative self-referential thoughts.
       
  • MATERNAL SUPPPLEMENTATION WITH CONJUGATED LINOLEIC ACID REDUCE ANXIETY AND
           LIPID PEROXIDATION IN THE OFFSPRING BRAIN
    • Abstract: Publication date: Available online 11 September 2018Source: Journal of Affective DisordersAuthor(s): Michelly Pires Queiroz, Martiniano da Silva Lima, Marília Ferreira Frazao Tavares de Melo, Camila Carolina de Menezes Santos Bertozzo, Daline Fernandes de Araújo, Gerlane Coelho Bernardo Guerra, Rita de Cassia Ramos do Egypto Queiroga, Juliana Késsia Barbosa Soares BackgroundMaternal consumption of fatty acids can alter neuronal membrane function, synaptic connections, and protect the brain from alterations caused by disturbances such as lipid peroxidation and anxiety in the offspring. We aimed to investigate how the maternal consumption of conjugated linoleic acid (CLA) interferes in anxiety behavior of the offspring and cerebral lipid peroxidation.MethodsThree groups were formed: control (CG) - diet without CLA; CLA1 - diet containing 1% of CLA; and CLA3 - diet containing 3% of CLA. These diets were offered to the mothers from the 7th day of gestation until the end of lactation. The following behavioral tests were used: Elevated plus maze (EPM), Open Field (OF) and Light-dark Box (LDB). Levels of malondialdehyde (MDA) and glutathione were measured in the offspring's brains. Data were analyzed by ANOVA followed by the Holm-Sidak post-test or the Kruskal-Wallis test (p
       
  • Adolescent and adult differences in major depression symptom profiles
    • Abstract: Publication date: Available online 11 September 2018Source: Journal of Affective DisordersAuthor(s): F. Rice, L. Riglin, T. Lomax, E. Souter, R. Potter, D.J. Smith, A.K. Thapar, A. Thapar BackgroundDepression is the leading global cause of disability and often begins in adolescence. The genetic architecture and treatment response profiles for adults and adolescents differ even though identical criteria are used to diagnose depression across different age groups. There is no clear consensus on how these groups differ in their symptom profiles.MethodsUsing data from a two-generation family study, we compared the presentation of DSM-IV depressive symptoms in adolescents and adults with MDD (Major Depressive Disorder). We also compared DSM-IV depressive symptom counts using latent class analysis.ResultsVegetative symptoms (appetite and weight change, loss of energy and insomnia) were more common in adolescent MDD than adult MDD. Anhedonia/loss of interest and concentration problems were more common in adults with MDD. When using latent class analysis to look at depressive symptoms, a vegetative symptom profile was also seen in adolescent depression only.LimitationsAdults and adolescents were recruited in different ways. Adolescent cases were more likely to be first-onset while adult cases were recurrences. It was not possible to examine how recurrence affected adolescent depression symptom profiles.ConclusionDifferences in how depression presents in adolescents and adults may be consistent with different pathophysiological mechanisms. For adolescents, we found that vegetative/physical disturbances were common (loss of energy, changes in weight, appetite and sleep changes). For adults, anhedonia/loss of interest and concentration difficulties were more common.
       
  • Dysfunctional Attitudes or Extreme Response Style as Predictors of
           Depressive Relapse and Recurrence after Mobile Cognitive Therapy for
           Recurrent Depression
    • Abstract: Publication date: Available online 8 September 2018Source: Journal of Affective DisordersAuthor(s): Marlies E. Brouwer, Alishia D. Williams, Nicholas R. Forand, Robert J. DeRubeis, Claudi L.H. Bockting BackgroundAccording to previous research, dysfunctional attitudes and/or scoring extreme on the end-point anchors of questionnaires of dysfunctional thinking predict depressive relapse/recurrence. Evidence that these two methods represent a risk for depressive relapse/recurrence is however mixed, due to differential or poorly defined concepts. The current study aimed to test the two methods.MethodsRemitted recurrently depressed patients with low residual depressive symptoms (N = 264) were recruited as part of a randomized controlled trial of the effectiveness of mobile Cognitive Therapy for recurrent depression versus treatment as usual. In the current secondary analysis, Cox regression models were conducted to test dysfunctional attitudes and extreme responding variables (assessed on the Dysfunctional Attitudes Scale [DAS]) as predictors of depressive relapse/recurrence within two years after randomization.ResultsData from 255 participants were analyzed. Results showed that DAS total scores at baseline significantly predicted depressive relapse/recurrence (Hazard Ratio [HR] = 1.01, p =.042). An index that reflects endorsement of habitual relative to functional responses was a significant predictor of depressive relapse/recurrence (HR = 2.11, p = .029).LimitationsThe current study employed a single measure to identify extreme responses and dysfunctional attitudes. Secondly, various statistical analyses were performed without correcting for multiple testing, which in turn increased the likelihood to finding significant results.ConclusionsCurrent study confirmed both methods: People who scored higher on the DAS or had relatively more habitual than functional responses on the extreme positive ends of the DAS had a decreased time to depressive relapse/recurrence.
       
  • The Role of Substance Use, Smoking, and Inflammation in Risk for Suicidal
           Behavior
    • Abstract: Publication date: Available online 7 September 2018Source: Journal of Affective DisordersAuthor(s): He Benny Chang, Sara Munroe, Katarina Gray, Giovanna Porta, Antoine Douaihy, Anna Marsland, David Brent, Nadine M. MelhemABSTRACTBackgroundAlcohol and substance use disorders are important predictors for suicidal behavior. However, the role of individual substances as proximal risk factors for suicidal behavior and the mechanisms through which substance use affect risk are not entirely clear. We examine whether the frequency of substance use and whether biological markers in the HPA axis and inflammatory pathways are associated with clinical risk factors of suicidal behavior of aggression, impulsivity, hopelessness, and poor sleep.MethodsThe sample consisted of psychiatric inpatients, aged 15-30 years, admitted for suicide attempt (n=38), suicidal ideation (n=40); and healthy controls (n=37). We measured hair cortisol concentrations, glucocorticoid receptor (GR) sensitivity, stimulated production of interleukin- or IL-6, C-Reactive Protein, and mRNA expression of GR, SKA2, FKBP5, TNF-α, and IL-1β.ResultsSmoking was associated with increased aggression [β= 2.9, 95% CI (-0.03, 6), p=0.05], impulsivity [β= 3.1, 95% CI (1.6, 4.6), p
       
  • Similar profiles of cognitive domain deficits between medication-naïve
           patients with bipolar II depression and those with major depressive
           disorder
    • Abstract: Publication date: Available online 31 May 2018Source: Journal of Affective DisordersAuthor(s): Tao Liu, Shuming Zhong, Bing Wang, Xiaoxiao Liao, Shunkai Lai, Yanbin Jia BackgroundBipolar disorder (BD) II is more likely to be misdiagnosed as major depressive disorder (MDD) than other types of BD, leading to incorrect treatment and poor outcomes. Previous studies have shown inconsistent results regarding the differences in cognitive deficits between the two disorders. To eliminate the compounding effects of medication and aging, we sought to investigate changes in cognitive function in medication-naïve, non-late-life patients with BDII and MDD.MethodsThree subject groups were enrolled: 30 depressed BDII patients, 30 depressed MDD patients and 30 healthy controls. All subjects underwent a battery of cognitive tests to assess 8 cognitive domains. The cognitive domains were compared between the three subject groups. In BDII and MDD, the effect sizes were computed as evaluation parameters, weighing the degree of the cognitive deficits and the correlations between cognitive test deficits and clinical variables were also computed.ResultsCompared with the controls, the BDII and MDD patients were characterized by similar deficits in psychomotor speed, working memory, visual memory, attention switching and verbal fluency. Moderate to severe deficits in the majority of cognitive tests were observed in the BDII and MDD patients. Furthermore, correlations between the modified Wisconsin Card Sorting Test total errors and age of onset in the BDII patients and between correct digit span responses (backward and total) and depressive severity were found in the MDD patients.ConclusionsOur findings suggest that BDII and MDD patients may suffer from similar profiles of cognitive domain deficits that may not assist in distinguishing between the two disorders. In addition, cognitive deficits may be correlated with the age of onset and depressive severity in mood disorders.
       
 
 
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